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Pediatric large volume peripheral blood progenitor cell collections from patients under 25kg: A primer
Author(s) -
Gorlin Jed B.,
Humphreys Donald,
Kent Patricia,
Galacki Dolores,
Kevy Sherwin V.,
Grupp Steve,
Diller Lisa,
Weinstein Howard,
Grier Holcombe,
Shamberger Robert
Publication year - 1996
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/(sici)1098-1101(1996)11:4<195::aid-jca4>3.0.co;2-6
Subject(s) - medicine , progenitor cell , blood volume , packed red blood cells , cd34 , venous access , vacutainer , peripheral blood , surgery , catheter , anesthesia , stem cell , blood transfusion , genetics , biology
Collection of peripheral blood progenitor cells from small pediatric patients provides many social and technical challenges not faced when collecting from adult patients. This paper provides a single institutions experience with 85 collections from 14 patients less than 25 kg of weight over a 2 year period. Specific challenges include obtaining venous access, anticoagulation, volume shifts, and obtaining patient cooperation. A systematic analysts of options for access, alternative modes of anticoagulation, and the effect of large ratios of extra‐corporeal volume to patient's blood volume are discussed. Access uniformly required central venous catheters (CVC) ranging from 7–10 Fr Anticoagulation included systemic heparmization titrating dose by activated clotting time in all cases and combined with nitrate at a ratio of 1:25 · 1:30 in most cases. Collections were performed on a COBE. Spectra, after priming with leukoreduced irradiated red cells and omitting both the initial 120cc diversion and rinse back of red cells at the end Social challenges include issues of assent and ability to distract patients for the duration of a prolonged collection. Progenitor yields from collections from 14 patients were quantitiated by CD34+ assay in all cases and C???GM in ten of 14 patients. A median of 4.5 + 10 6 /kg CD34+ cells were obtained for each collection. Complications, including those related to catheter access are enumerated. In summary, large volume peripheral blood progenitor collection can be safely and efficaciously performed in small pediatric patients. © 1996 Wiley‐Liss, Inc.