Hematologic Recovery after Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Children with High-Risk Solid Tumors.
10.3346/jkms.2013.28.2.220
- Author:
Meong Hi SON
1
;
Dong Hwan KIM
;
Soo Hyun LEE
;
Keon Hee YOO
;
Ki Woong SUNG
;
Hong Hoe KOO
;
Ju Youn KIM
;
Eun Joo CHO
;
Eun Suk KANG
;
Dae Won KIM
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kwsped@skku.edu
- Publication Type:Original Article
- Keywords:
High-Dose Chemotherapy;
Autologous Stem Cell Transplantation;
CD34+ Cells;
Hematologic Recovery;
Iron Overload
- MeSH:
Adolescent;
Antigens, CD34/metabolism;
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use;
Blood Cell Count;
Blood Platelets/cytology;
Child;
Child, Preschool;
Combined Modality Therapy;
Erythrocytes/cytology;
Female;
Ferritins/blood;
Humans;
Infant;
Male;
Neoplasms/*drug therapy;
Neutrophils/cytology;
Retrospective Studies;
*Stem Cell Transplantation;
Stem Cells/cytology/metabolism;
Transplantation, Autologous;
Young Adult
- From:Journal of Korean Medical Science
2013;28(2):220-226
- CountryRepublic of Korea
- Language:English
-
Abstract:
Although the number of studies using tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) for the treatment of high-risk pediatric solid tumors has been increasing, documentation of hematologic recovery after tandem HDCT/autoSCT is very limited. For this reason, we retrospectively analyzed the hematologic recovery of 236 children with high-risk solid tumors who underwent tandem HDCT/autoSCT. The median numbers of CD34+ cells transplanted during the first and second HDCT/autoSCT were 4.3 x 10(6)/kg (range 0.6-220.2) and 4.1 x 10(6)/kg (range 0.9-157.6), respectively (P = 0.664). While there was no difference in neutrophil recovery between the first and second HDCT/autoSCT, platelet and RBC recoveries were significantly delayed in the second HDCT/autoSCT (P < 0.001 and P < 0.001, respectively). Delayed recovery in the second HDCT/autoSCT was more prominent when the number of transplanted CD34+ cells was lower, especially if it was < 2 x 10(6)/kg. A lower CD34+ cell count was also associated with increased RBC transfusion requirements and a higher serum ferritin level after tandem HDCT/autoSCT. More CD34+ cells need to be transplanted during the second HDCT/autoSCT in order to achieve the same hematologic recovery as the first HDCT/autoSCT.
