AlAnazi Awatif, Nadeem Amer, Siddiqui Khawar, AlAhmari Ali, Ghemlas Ibrahim, AlJefri Abdullah, AlSaedi Hawazen, Khan Saadiya, Ayas Mouhab
Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Blood Res. 2023 Mar 31;58(1):28-35. doi: 10.5045/br.2023.2022167. Epub 2023 Jan 12.
Reduced harvest volumes in pediatric donors appear to have the potential to reduce donor-associated risks while maintaining engraftment in recipients; however, the allowable harvest volume reduction remains undefined.
We retrospectively analyzed the data pairs of 553 bone marrow (BM) harvests from pediatric (age at harvest <18 yr) sibling donors and clinical outcomes of 553 pediatric (age at infusion <14 yr) transplant-naïve recipients to assess the optimal BM harvest volume needed from pediatric donors to obtain the desired CD34+ cell count (≥3.0×10 cells per kg of recipient weight), and to study its impact on the clinical outcomes of transplantation in pediatric recipients.
The minimum desired CD34+ cell count of ≥3.0×10 per kg of recipient weight was achieved for 506 (95.3%) of donor-recipient pairs. The median CD34+ cell yield was 6.4×10 per kg of recipient weight (range, 1.2‒33.8×10) in donors younger than 5 years old at harvest, 4.7×10 (range, 0.3‒28.5×10) in donors aged 5‒10 years and 2.1×10 (range, 0.3‒11.3×10) in donors older than 10 years (<0.001).
The infused CD34+ cell dose (×10 cells/kg of recipient weight) had no impact on GRFS; however, a CD34+ cell dose of ＞7×10 cells/kg of recipient weight did not improve hematopoietic recovery.
儿科供者采集量减少似乎有可能降低与供者相关的风险，同时维持受者的植入；然而，可允许的采集量减少幅度仍未明确。
我们回顾性分析了553例儿科（采集时年龄<18岁）同胞供者骨髓采集的数据对，以及553例儿科（输注时年龄<14岁）未接受过移植的受者的临床结局，以评估儿科供者获得所需CD34+细胞计数（≥3.0×10⁶个细胞/每千克受者体重）所需的最佳骨髓采集量，并研究其对儿科受者移植临床结局的影响。
506对（95.3%）供受者对达到了每千克受者体重≥3.0×10⁶个细胞的最低期望CD34+细胞计数。采集时年龄小于5岁的供者，CD34+细胞产量中位数为每千克受者体重6.4×10⁶个细胞（范围为1.2‒33.8×10⁶）；5‒10岁供者为4.7×10⁶个细胞（范围为0.3‒28.5×10⁶）；大于10岁的供者为2.1×10⁶个细胞（范围为0.3‒11.3×10⁶）（P<0.001）。
输注的CD34+细胞剂量（×10⁶个细胞/每千克受者体重）对粒细胞恢复功能状态无影响；然而，CD34+细胞剂量>7×10⁶个细胞/每千克受者体重并不能改善造血恢复。
