Allogeneic Peripheral Blood Stem Cell Transplantation from An HLA-identical Sibling Donor in Children.
- Author:
Keon Hee YOO
1
;
Kee Woon MIN
;
Soo Hyun LEE
;
Ki Woong SUNG
;
Dae Won KIM
;
Eun Joo CHO
;
Hong Hoe KOO
Author Information
1. Department of Pediatrics, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. hhkoo@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Allogeneic peripheral blood stem cell transplantation;
HLA-identical sibling donor;
Children;
Large volume leukapheresis;
Mega-dose
- MeSH:
Autografts;
Blood Platelets;
Child*;
Granulocyte Colony-Stimulating Factor;
Hematopoietic Stem Cells;
Humans;
Leukapheresis;
Leukemia, Biphenotypic, Acute;
Mortality;
Neuroblastoma;
Peripheral Blood Stem Cell Transplantation*;
Recurrence;
Siblings*;
Tissue Donors*
- From:Korean Journal of Pediatric Hematology-Oncology
2003;10(2):214-222
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: G-CSF-mobilized peripheral blood is one of the sources of allogeneic hematopoietic stem cells. We report our experiences on allogeneic peripheral blood stem cell transplantation (allo-PBSCT) from an HLA-identical sibling donor in children. METHODS: From August 1998 to January 2003, 8 patients underwent allo-PBSCT. Median age of recipients and donors were 4 yr 10 mo (range 3 yr 2 mo 15 yr) and 5 yr 1 mo (range 1 yr 11 mo 19 yr 8 mo), respectively. Seven patients (3 ALL, 2 neuroblastomas, 1 AML, 1 Gaucher disease) had failed from previous allogeneic or autologous transplant and 1 patient had refractory acute biphenotypic leukemia. Only 2 patients were in complete remission at allo-PBSCT. G-CSF 10mug/kg/day was injected subcutaneously to the donor for 5 days and large volume leukapheresis was performed on 4th and 5th days. RESULTS: Median number of CD34 and CD3 cells infused was 18.55 106 (range 9.47 84.76) /kg and 8.26 108 (range 0.88 24.58) /kg, respectively. All patients achieved ANC > 0.5 109/L after a median of 9 days and 6 patients eventually achieved platelet engraftment. There was no grade II-IV acute GVHD but limited chronic GVHD developed in 6 evaluable patients. There was no CMV antigenemia. Three patients died from either transplant-related mortality (n=2) or relapse (n=1). The remaining 5 patients are alive disease-free for 7, 8, 15, 16, and 19 months from allo-PBSCT, respectively. CONCLUSION: Our results suggest that mega-dose allo-PBSCT from an HLA-identical sibling donor is expected to improve transplant outcome especially in very high risk pediatric patients.
