Brust Patrick, Schubert Claudia, Blohm Martin, Winkler Beate
Clinic of Pediatric Oncology and Hematology.
University Medical Center Hamburg-Eppendorf, University Children's Hospital, Hamburg, Germany.
J Pediatr Hematol Oncol. 2020 Oct;42(7):e692-e695. doi: 10.1097/MPH.0000000000001745.
Peripheral blood stem cell apheresis has become a routine procedure for the collection of peripheral blood stem cells to enable high-dose chemotherapy followed by autologous stem cell transplantation in high-risk pediatric malignancies. However, the procedure remains challenging in very low-weight infants due to high extracorporeal blood volume and citrate toxicity. Our case report demonstrates in detail a successful and complication-free large-volume leukapheresis in a very small infant weighing 6 kg using a Spectra Optia apheresis system after placing a femoral double-lumen Shaldon catheter. Anticoagulation was achieved by citrate dextrose solution without the use of heparin. The total amount of blood being processed during the procedure equaled almost 4 times the total blood volume of the patient. The final apheresis product contained 14.0×10 CD34 cells/kg body weight. The infant was diagnosed with an atypical teratoid/rhabdoid tumor of the thalamus and third ventricle at the age of 3 months and had a history of epileptic seizures.
外周血干细胞单采已成为采集外周血干细胞的常规程序，以便在高危儿童恶性肿瘤中进行大剂量化疗后进行自体干细胞移植。然而，由于体外循环血量高和枸橼酸盐毒性，该程序在极低体重婴儿中仍然具有挑战性。我们的病例报告详细展示了在一名体重6公斤的非常小的婴儿中，使用Spectra Optia单采系统，在置入股静脉双腔Shaldon导管后成功进行了无并发症的大容量白细胞单采。通过使用枸橼酸葡萄糖溶液进行抗凝，未使用肝素。该过程中处理的血液总量几乎等于患者总血容量的4倍。最终的单采产品含有14.0×10 CD34细胞/公斤体重。该婴儿在3个月大时被诊断为丘脑和第三脑室的非典型畸胎样/横纹肌样肿瘤，并有癫痫发作史。
