Korístek Z, Sterba J, Havranová D, Mayer J
Department of Internal Medicine - Hematooncology, Masaryk University Hospital, Brno, Czech Republic.
Bone Marrow Transplant. 2002 Jan;29(1):57-61. doi: 10.1038/sj.bmt.1703334.
Peripheral blood stem cell (PBSC) harvesting in the smallest children (weight <10 kg) using separators is complicated by specific problems. The volume of the separation set exceeds 25% of the total blood volume and the vascular access is generally not sufficient. Therefore, a simple manual technique for PBSC harvesting was developed. Three children (6-9 kg), with newly diagnosed tumours were scheduled to be treated with three to six sequential courses of high-dose chemotherapy, each followed by PBSC support. PBSC harvests were started after mobilization using cyclophosphamide and G-CSF when the peripheral blood CD34+ cell count exceeded 50/microl. About 50 ml of blood was drawn from a venous catheter, injected into a transfer bag containing ACD-A, and centrifuged. The buffy coat obtained was pooled in a collection bag, remaining plasma and erythrocytes were immediately reinfused and a subsequent cycle started. From three to 13 cycles were performed in 1-3 days and 18.0-32.2 x 10(6) CD34+cells/kg were collected. We did not detect any bacterial contamination or any notable complications. Fifteen PBSC reinfusions have been performed to date, each with rapid engraftment taking between 7 and 13 days. Patients are in very good PR (18 months from diagnosis) or in CR (6 and 8 months). We can conclude that this procedure is feasible and safe.
对于最小的儿童（体重<10kg）使用血细胞分离机采集外周血干细胞（PBSC）存在一些特殊问题。分离装置的体积超过总血容量的25%，而且血管通路通常也不充足。因此，开发了一种简单的手动采集PBSC的技术。三名新诊断为肿瘤的儿童（体重6-9kg）计划接受三到六个疗程的大剂量化疗，每个疗程后接受PBSC支持。当外周血CD34+细胞计数超过50/μl时，使用环磷酰胺和粒细胞集落刺激因子（G-CSF）动员后开始采集PBSC。从静脉导管抽取约50ml血液，注入含有ACD-A的转移袋中，然后进行离心。获得的血沉棕黄层收集到一个采集袋中，剩余的血浆和红细胞立即回输，并开始下一个循环。在1-3天内进行了三到十三个循环，采集到18.0-32.2×10⁶个/kg的CD34+细胞。我们未检测到任何细菌污染或任何明显的并发症。迄今为止已进行了15次PBSC回输，每次回输后均在7至13天内迅速植入。患者目前处于非常好的部分缓解（PR，诊断后18个月）或完全缓解（CR，诊断后6个月和8个月）状态。我们可以得出结论，该方法是可行且安全的。
