Shen V, Woodbury C, Killen R, Van de Ven C, Sender L, Cairo M S
Division of Pediatric Hematology/Oncology, Children's Hospital of Orange County, Orange, CA 92668, USA.
Bone Marrow Transplant. 1997 Feb;19(3):197-204. doi: 10.1038/sj.bmt.1700648.
Fifteen children 4 years of age or under (8-46 months), weight 7.8 to 17 kg, underwent 44 peripheral blood stem cell (PBSC) collections. Diagnoses included PNET/medulloblastoma (five), neuroblastoma (five), and others (five). PBSCs were collected following G-CSF/GM-CSF or chemotherapy plus G-CSF/GM-CSF mobilization. All PBSC collections were well tolerated. The average yield per collection was 6.80 x 10(8) mononuclear cells/kg (1.1-30 x 10(8)/kg) or 57.60 x 10(6) CD34+/kg (1.37 to 480 x 10(6)/kg). Eight patients underwent stem cell transplantation following myeloablative chemotherapy. Six of the eight children who received PBSC following myeloablative therapy also received autologous bone marrow (0.7 to 3.6 x 10(8) MNC/kg). One heavily pretreated patient experienced delayed hematologic reconstitution, while the remaining seven patients had a median ANC recovery to > 0.5 x 10(3)/microliter by day +10 (9-11 days) and platelets > 50 x 10(3)/microliter by day +15 (12-17 days). Seven patients received PBSCs following repetitive submyeloablative chemotherapy (ICE: ifosfamide 1.8 g/m2/day, etoposide 100 mg/m2/day x 5, carboplatin 400 mg/m2/day x 2) or other similar combination chemotherapy. Median days to recover ANC > or = 1 x 10(3)/microliter and platelets > or = 100 x 10(3)/microliter in children receiving ICE + PBSCs were 10 and 14 days, respectively, compared with 16 and 22 days in children receiving ICE + G-CSF in historical controls. In conclusion, collection and use of PBSCs to support either myeloablative chemotherapy or multicycle submyeloablative chemotherapy is well tolerated and may enhance hematological recovery in young children and infants.
15名4岁及以下（8 - 46个月）、体重7.8至17千克的儿童接受了44次外周血干细胞（PBSC）采集。诊断包括原始神经外胚层肿瘤/髓母细胞瘤（5例）、神经母细胞瘤（5例）和其他疾病（5例）。PBSC采集在粒细胞集落刺激因子（G - CSF）/粒细胞巨噬细胞集落刺激因子（GM - CSF）或化疗加G - CSF/GM - CSF动员后进行。所有PBSC采集耐受性良好。每次采集的平均产量为6.80×10⁸个单核细胞/千克（1.1 - 30×10⁸/千克）或57.60×10⁶个CD34⁺/千克（1.37至480×10⁶/千克）。8例患者在清髓性化疗后接受了干细胞移植。在8例接受清髓性治疗后接受PBSC的儿童中，有6例还接受了自体骨髓（0.7至3.6×10⁸个有核细胞/千克）。1例预处理严重的患者出现血液学重建延迟，其余7例患者中性粒细胞绝对值（ANC）恢复至>0.5×10³/微升的中位时间为第10天（9 - 11天），血小板恢复至>50×10³/微升的中位时间为第15天（12 - 17天）。7例患者在重复亚清髓性化疗（ICE方案：异环磷酰胺1.8克/平方米/天，依托泊苷100毫克/平方米/天×5天，卡铂400毫克/平方米/天×2天）或其他类似联合化疗后接受了PBSC。接受ICE + PBSC的儿童中，ANC恢复至≥1×10³/微升和血小板恢复至≥100×10³/微升的中位天数分别为10天和14天，而历史对照中接受ICE + G - CSF的儿童分别为16天和22天。总之，采集和使用PBSC来支持清髓性化疗或多周期亚清髓性化疗耐受性良好，可能会促进幼儿和婴儿的血液学恢复。
