Effectiveness and challenges of apheresis of peripheral blood stem cells in children with malignant neoplasms: results of a single-center study

Peripheral blood stem cell apheresis (PBSC) is an effective and safe method of collecting hematopoietic stem cells (HSC) in patients with malignant neoplasms (MN) for subsequent high-dose chemotherapy (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT) compared to myeloexfusion. Optimization of the method for young children in terms of increasing efficiency and reducing the risks of associated complications remains a challenge. The article presents a single-center retrospective analysis of PBSC apheresis in children with cancer. The study included 97 patients who underwent 138 PBSC apheresis. The median age was 2 years 11 months, the median body weight was 16.05 kg. Mobilization of CD34+ cells was performed with filgrastim, in 2 cases with plerixafor. By the day of apheresis, the median CD34+ cell count was 100.5 (10.5–1032) cells/µl. The absolute CD34+ cell count as a result of 1 session ranged from 0.38 to 71.91, the median was 4.8·106/kg. Factors influencing the efficiency of PBSC apheresis were lower body weight (p=0.039), fewer courses of previous antitumor therapy (p=0.002), and a higher number of HSCs (CD34+/45+) in 1 µl of peripheral blood based on the mobilization results (p=0.001). There were no complications associated with the apheresis procedure. Adequate preparation and the proper concomitant therapy, taking into account the prediction of all risks, allow preventing complications and performing PBSC apheresis with a satisfactory result.