Marson P, Petris M G, Messina C, Cecchetto G, Giordano R, Zanesco L, De Silvestro G
Servizio di Immunoematologia e Trasfusionale, Azienda Ospedaliera di Padova.
Minerva Pediatr. 2000 Mar;52(3):129-35.
Leukapheresis for peripheral blood stem cell collection is increasingly being carried out in pediatric cancer patients. Aim of this study was to report experience of the Padua Apheresis Unit on a series of children weighting < 15 kg who have undergone such an apheresis procedure.
This retrospective study includes 15 pediatric patients affected with various malignancies (neuroblastoma: 7; acute myelogenous leukemia: 3; rhabdomyosarcoma: 2; PNET: 1; retinoblastoma: 1; Burkitt's lymphoma: 1) collecting peripheral blood stem cells by a Cobe Spectra blood cell separator. Main procedure parameters, including vascular access, leukapheresis duration, blood flow rate, processed blood volumes, side effects, mononuclear and CD34+ cell yields, have been registered.
Altogether 22 sessions have been carried out, by processing a mean of 2.8 blood volumes. No leukapheresis related complications have been recorded, such as hypotension, hypocalcemia and hypothermia. Noteworthy, in 4 procedures two or more peripheral venipunctures have been performed to ensure an adequate blood flow.
Leukapheresis for peripheral blood stem cell collection can be safely and efficaciously carried out in pediatric patients, even weighing < 15 kg, on the condition that certain aspects of apheresis practice in children (vascular access, volume shifts, anticoagulation, side effects) are carefully considered.
外周血干细胞采集的白细胞分离术在儿科癌症患者中越来越普遍。本研究旨在报告帕多瓦单采血浆中心对一系列体重<15kg的儿童进行这种白细胞分离术的经验。
这项回顾性研究纳入了15例患有各种恶性肿瘤的儿科患者（神经母细胞瘤：7例；急性髓性白血病：3例；横纹肌肉瘤：2例；原始神经外胚层肿瘤：1例；视网膜母细胞瘤：1例；伯基特淋巴瘤：1例），使用Cobe Spectra血细胞分离机采集外周血干细胞。记录了主要操作参数，包括血管通路、白细胞分离术持续时间、血流速度、处理的血量、副作用、单核细胞和CD34+细胞产量。
共进行了22次操作，平均处理2.8个血容量。未记录到与白细胞分离术相关的并发症，如低血压、低钙血症和体温过低。值得注意的是，在4次操作中进行了两次或更多次外周静脉穿刺以确保足够的血流。
外周血干细胞采集的白细胞分离术在儿科患者中，即使体重<15kg，只要仔细考虑儿童白细胞分离术操作的某些方面（血管通路、容量变化、抗凝、副作用），就可以安全有效地进行。
