Allogeneic peripheral blood stem cell transplantation using normal patient-related pediatric donors

M. Körbling, K. W. Chan, P. Anderlini, D. Seong, A. Durett, A. Langlinais, D. Przepiorka, J. Gajewski, P. Miller, J. Sundberg, P. Alilaen, P. Bojko, N. Mirza, D. Claxton, K. Van Besien, I. Khouri, B. Andersson, R. Mehra, R. Champlin

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Successful allogeneic peripheral blood progenitor cell (PBPC) transplantation has recently been reported by several transplant centers. This is a first report describing allogeneic PBPC transplantation in five patients using related pediatric donors between the ages of 4 and 13 years. Donors underwent 3 or 4 days of rhG-CSF treatment (6 μg/kg q 12 h) for stem cell peripheralization prior to PBPC collection, which was performed by continuous-flow apheresis on day 4 or 5. Venous access was exclusively by ante-cubital veins. A median of 2.2 times (range 1.4-3.6) the donor's total blood volume (TBV) was processed per procedure. In cases where the donor's TBV was <2 liters, the blood cell separator was primed with human serum albumin (HSA-5%), and anticoagulation was performed using a combination of heparin (pre-apheresis bolus + continuous infusion (CI)) and/or ACD-A (CI at a reduced rate). The median number of CD34+ cells collected per kg of donor body weight (b.w.) and per liter of donor blood processed during each procedure was 128 x 104 (range 58 x 104-314 x 104). Between one and two aphereses were sufficient to collect a safe CD34+ cell engraftment dose of 3 or 4 x 106/kg of recipient b.w. Two PBPC recipients were parents, and three were siblings. After freezing and thawing, the median number of CD34+ cells per kg of recipient b.w. thawed and transfused was 8.5 x 106 (range 3.2 x 106-9.7 x 106). The time to PMN > 1000/μl was between 10 and 16 days (four out of five evaluable patients), and platelets > 20,000/μl were reached between day 13 and 14 post-transplantation (three out of five evaluable patients). Two out of three evaluable patients developed grades one and three acute GVHD, and one out of three developed chronic GVHD. Two patients died of sepsis and VOD at day 10 and 19, respectively. Two adult patients are alive and in cytogenetic and molecular remission of CML at +339 and +227 days post-allotransplantation. One 3-year-old girl with hemophagocytic lymphohistiocytosis is in remission at +304 days post-transplantation. Using pediatric donors for allogeneic PBPC transplantation appears to be safe, yields a sufficient amount of progenitors for prompt engraftment, and results in clinical outcome similar to adult PBPC allotransplantation.

Original languageEnglish (US)
Pages (from-to)885-890
Number of pages6
JournalBone Marrow Transplantation
Volume18
Issue number5
StatePublished - Nov 1996
Externally publishedYes

Fingerprint

Peripheral Blood Stem Cell Transplantation
Stem Cells
Tissue Donors
Blood Cells
Pediatrics
Cell Transplantation
Blood Volume
Transplantation
Hemophagocytic Lymphohistiocytosis
Blood Component Removal
Cytogenetics
Veins
Sepsis
Blood Platelets
Transplants

Keywords

  • Allogeneic blood stem cell transplantation
  • Apheresis
  • Normal pediatric blood stem cell donors
  • rhG-CSF stem cell mobilization

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Körbling, M., Chan, K. W., Anderlini, P., Seong, D., Durett, A., Langlinais, A., ... Champlin, R. (1996). Allogeneic peripheral blood stem cell transplantation using normal patient-related pediatric donors. Bone Marrow Transplantation, 18(5), 885-890.

Allogeneic peripheral blood stem cell transplantation using normal patient-related pediatric donors. / Körbling, M.; Chan, K. W.; Anderlini, P.; Seong, D.; Durett, A.; Langlinais, A.; Przepiorka, D.; Gajewski, J.; Miller, P.; Sundberg, J.; Alilaen, P.; Bojko, P.; Mirza, N.; Claxton, D.; Van Besien, K.; Khouri, I.; Andersson, B.; Mehra, R.; Champlin, R.

In: Bone Marrow Transplantation, Vol. 18, No. 5, 11.1996, p. 885-890.

Research output: Contribution to journalArticle

Körbling, M, Chan, KW, Anderlini, P, Seong, D, Durett, A, Langlinais, A, Przepiorka, D, Gajewski, J, Miller, P, Sundberg, J, Alilaen, P, Bojko, P, Mirza, N, Claxton, D, Van Besien, K, Khouri, I, Andersson, B, Mehra, R & Champlin, R 1996, 'Allogeneic peripheral blood stem cell transplantation using normal patient-related pediatric donors', Bone Marrow Transplantation, vol. 18, no. 5, pp. 885-890.
Körbling M, Chan KW, Anderlini P, Seong D, Durett A, Langlinais A et al. Allogeneic peripheral blood stem cell transplantation using normal patient-related pediatric donors. Bone Marrow Transplantation. 1996 Nov;18(5):885-890.
Körbling, M. ; Chan, K. W. ; Anderlini, P. ; Seong, D. ; Durett, A. ; Langlinais, A. ; Przepiorka, D. ; Gajewski, J. ; Miller, P. ; Sundberg, J. ; Alilaen, P. ; Bojko, P. ; Mirza, N. ; Claxton, D. ; Van Besien, K. ; Khouri, I. ; Andersson, B. ; Mehra, R. ; Champlin, R. / Allogeneic peripheral blood stem cell transplantation using normal patient-related pediatric donors. In: Bone Marrow Transplantation. 1996 ; Vol. 18, No. 5. pp. 885-890.
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AU - Körbling, M.

AU - Chan, K. W.

AU - Anderlini, P.

AU - Seong, D.

AU - Durett, A.

AU - Langlinais, A.

AU - Przepiorka, D.

AU - Gajewski, J.

AU - Miller, P.

AU - Sundberg, J.

AU - Alilaen, P.

AU - Bojko, P.

AU - Mirza, N.

AU - Claxton, D.

AU - Van Besien, K.

AU - Khouri, I.

AU - Andersson, B.

AU - Mehra, R.

AU - Champlin, R.

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N2 - Successful allogeneic peripheral blood progenitor cell (PBPC) transplantation has recently been reported by several transplant centers. This is a first report describing allogeneic PBPC transplantation in five patients using related pediatric donors between the ages of 4 and 13 years. Donors underwent 3 or 4 days of rhG-CSF treatment (6 μg/kg q 12 h) for stem cell peripheralization prior to PBPC collection, which was performed by continuous-flow apheresis on day 4 or 5. Venous access was exclusively by ante-cubital veins. A median of 2.2 times (range 1.4-3.6) the donor's total blood volume (TBV) was processed per procedure. In cases where the donor's TBV was <2 liters, the blood cell separator was primed with human serum albumin (HSA-5%), and anticoagulation was performed using a combination of heparin (pre-apheresis bolus + continuous infusion (CI)) and/or ACD-A (CI at a reduced rate). The median number of CD34+ cells collected per kg of donor body weight (b.w.) and per liter of donor blood processed during each procedure was 128 x 104 (range 58 x 104-314 x 104). Between one and two aphereses were sufficient to collect a safe CD34+ cell engraftment dose of 3 or 4 x 106/kg of recipient b.w. Two PBPC recipients were parents, and three were siblings. After freezing and thawing, the median number of CD34+ cells per kg of recipient b.w. thawed and transfused was 8.5 x 106 (range 3.2 x 106-9.7 x 106). The time to PMN > 1000/μl was between 10 and 16 days (four out of five evaluable patients), and platelets > 20,000/μl were reached between day 13 and 14 post-transplantation (three out of five evaluable patients). Two out of three evaluable patients developed grades one and three acute GVHD, and one out of three developed chronic GVHD. Two patients died of sepsis and VOD at day 10 and 19, respectively. Two adult patients are alive and in cytogenetic and molecular remission of CML at +339 and +227 days post-allotransplantation. One 3-year-old girl with hemophagocytic lymphohistiocytosis is in remission at +304 days post-transplantation. Using pediatric donors for allogeneic PBPC transplantation appears to be safe, yields a sufficient amount of progenitors for prompt engraftment, and results in clinical outcome similar to adult PBPC allotransplantation.

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