Results of mobilization, apheresis and autoreinfusion of hematopoietic stem cells in children with neuroblastoma: role of monitoring the count of CD34+ cells in peripheral blood

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Abstract

Myeloablative chemotherapy with autologous hematopoietic stem cells transplantation, can improve the results of long-term survival in patients with high-risk neuroblastoma. This treatment requires a sufficient number of autologous peripheral blood stem cells. Methods: 118 apheresis procedures was completed for 116 children with high-risk neuroblastoma, the median age was 2 years and 10 months (range, 6 months to 13 years), median body weight of 13 kg (range, 5.8 to 47 kg). Mobilization with G-CSF at a dose of 10 mg/kg was initiated at the time of incipient recovery of hematopoiesis after the last cycle of chemotherapy, monitoring of CD34+ cells in peripheral blood were started on 3rd day from the beginning of mobilization. Apheresis was performed the following day after reaching the number of CD34+ cells >15 cells/μl after 4 consequent days of mobilization. Results: Modification of mobilization, based on CD34+ cells monitoring data, allowed us to reach the median number of CD34+ cells of 105,27 cells/μl (range, 14.8–714.8) at the day of apheresis. The median number of collected CD34+/kg was 14,43×106/kg b.w. (range, 2.68–74). Was revealed a significant correlation between the dose of CD34+/kg b.w in the apheresis product and the level of CD34+ cells in peripheral blood at the day of apheresis (R=0.762; р<0.0001) and decrease of the results of mobilizing results and apheresis efficiency if mobilization was initiated later than after the 3rd course of chemotherapy. Conclusion: By monitoring the number of circulating CD34+ cells in peripheral blood and modification of mobilization tactic, the task to collect an adequate dose of CD34+ cells for autoSCT with one apheresis procedure was feasible. In 88 (75.86%) of the 116 patients we were able to collect 10×106/kg CD34+ cells and more, and 100% of patients collected > 2.5×106/kg CD34+ cells with 1 apheresis.

About the authors

E. E. Kurnikova

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Author for correspondence.
Email: elena.kurnikova@fccho-moscow.ru

MD, Department of Transfusion medicine

Russia 117997, Moscow, Samory Mashela st., 1

+7 (495) 287-6570, ext. 5223

Russian Federation

I. B. Kumukova

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

I. V. Guz

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

R. D. Chismatullina

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

T. V. Shamanskaya

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

M. S. Fadeeva

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

S. Y. Glushkova

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

V. V. Brilliantova

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

S. R. Varfolomeyeva

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

P. E. Trakhtman

National Reseach Practicle Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Russian Federation

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Copyright (c) 2017 Kurnikova E.E., Kumukova I.B., Guz I.V., Chismatullina R.D., Shamanskaya T.V., Fadeeva M.S., Glushkova S.Y., Brilliantova V.V., Varfolomeyeva S.R., Trakhtman P.E.

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