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HK J Paediatr (New Series)
Vol 1. No. 2,
1996
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HK J Paediatr (New Series) 1996;1:213
Proceedings of Clinical Meeting
Allogeneic Peripheral Blood Stem Cell Transplant A Feasible Alternative to Marrow Transplant for Children
SY Ha, GCF Chan, CK Chiu, CK Lam, RHS Liang, TK Chan, YL Lau SY Ha, GCF Chan, CK Chiu, CK Lam*, RHS Liang**, TK Chan**, YL Lau Departments of Paediatrics, Pathology*, Medicine**, Queen Mary Hospital
| HK J Paediatr (new series) 1996;1:207-220 The First Joint Scientific Meeting of Hong Kong College of Paediatricians and Guangdong Pediatric Society of the Chinese Medical Association
May 25, 1996 | Background Peripheral blood instead of marrow as a source of haemopoietic stem cell for allogeneic transplant has been increasingly used though there are pros and cons with this new approach. We evaluated our experience of employing a standardised protocol of peripheral blood stem cell (PBSC) harvest for allogeneic transplant. Methods and materials Donor was given G-CSF 10 μg/Kg/day subcutaneously for 4 days. Symptomatology, mononuclear cell (MNC), CD34 cell counts were monitored daily till harvest of PBSC on Day 5 using Baxter CS3000 machine. Collected products were infused to recipients non-cryopreserved. Day of engraftment, severity of GvHD and outcome were reviewed. Results Three patients underwent allogeneic PBSC transplant. Particulars of donors and recipients, content of PBSC, engraftment (recovery of blood count post-transplant) data were shown in table. Two donors had bone pain and 1 had flu-like syndrome while on G-CSF. White cell count rose above 40x109/L by D5 with steady increase of CD34+ cells. Cubital veins were used for venous access. Single stem cell harvest was performed in each. Transient thrombocytopenia was noted in two donors and hypocalcaemia in all. | No. | donor/
age (yr) | recipient
sex/age
(yr) | diagnosis | content of PBSC infused | engraftment day | MNC/Kg
x108 | CD34/Kg
x106 | CFU-GM@/Kg
x104 | neutro-phil
>500/μl | platelet
>20μl | | 1 | sister/12 | F/9 | MDS* | 9.5 | 26.5 | 17.9 | D20 | not yet | | 2 | father/41 | F/1.2 | rel.ALL# | 20.1 | 58.3 | 88.4 | D11 | D16 | | 3 | sister/11 | M/3 | MDS* | 8.8 | 107 | 33.4 | D19 | D29 | | #relapsed acute lymphoblastic leukaemia *myelodyspra @colony-forming-unit granulocyte monocyte | After PBSC infusion, all three recipients had rapid engraftment of granulocytic series. Case 1 developed grade IV acute graft versus host disease (GvHD) which evolved into chronic GvHD. GvHD was minimal for Case 2 and 3. Follow-up post-transplant was 120, 100, 70 days respectively. Case 2 was confirmed to have relapse on D90 post-transplant. Conclusion Allogeneic PBSC transplant is a feasible alternative to BMT for paediatric population. The complications experienced by donors were transient and tolerable. This protocol of PBSC harvest effectively collects stem cells which enable rapid engraftment after allogeneic transplant.
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