Procedure‐related complications and adverse events associated with pediatric autologous peripheral blood stem cell collection. Issue 1 (19th April 2016)

• Record Type: Journal Article
• Authors: Cooling, Laura; Hoffmann, Sandra; Webb, Dawn; Meade, Micheal; Yamada, Chisa; Davenport, Robertson; Yanik, Gregory
• Is Part Of: Journal of clinical apheresis. Volume 32:Issue 1(2017)
• Page Start: 35
• Page End: 48
• Publication Date: 2016-04-19
• Subjects: adverse event -- leukapheresis -- pediatric -- stem cell; Hemapheresis -- Periodicals; Blood -- Transfusion -- Periodicals; Blood -- Transfusion, Autologous -- Periodicals; Cell separation -- Periodicals; Leukapheresis -- Periodicals; Plasmapheresis -- Periodicals; 615.39
• DOI: 10.1002/jca.21465
• Languages: English
• ISSNs: 0733-2459

Abstract

Abstract : Introduction: Autologous peripheral blood hematopoietic progenitor cell collection (A‐HPCC) in pediatric patients is considered relatively safe although technically challenging. Very little is known regarding the incidence, risk factors and impact of procedure‐related adverse events (AE) on pediatric A‐HPCC outcomes.Methods : Prospective 4.5‐year review of AE associated with pediatric A‐HPCC. AE were graded by severity and type. Potential demographic and procedural risk factors, and the impact on product quality, were compared by t‐test, chi‐square, and linear regression.Results : Sixty‐two children underwent 110 A‐HPCC, including 36 (58%) under 20 kg. Fifty‐five AE were documented in 25.4% A‐HPCCs and 39% of children (citrate 25%, access 19%, technical 11%, cardiovascular 0%, allergic 1.8%). No AE were noted in children < 10 kg anticoagulated with heparin. Access and technical AE accounted for 73% of severe AE, with line‐related problems underlying most technical AE (87.5%, P = 0.006). AE were more likely in older ( P = 0.012), heavier patients ( P = 0.02), who frequently required more than one A‐HPCC ( P = 0.012). In contrast, young children were more likely to experience citrate AE with gastrointestinal symptoms (median age, 6 years; P = 0.076). AE had no impact on CD34 collection rates; however, mean CD34 yields (4.2 vs. 20.4 million/kg; P = 0.0035) were decreased in patients with technical AE due to lower peripheral CD34 counts and a high number of aborted procedures (37%).Conclusion : Venous access and flow‐related issues are a major factor associated with moderate and severe AE, effecting ∼10% of patients. AE are more frequent with increasing patient age, weight, and number of procedures. J. Clin. Apheresis 32:35–48, 2017. © 2016 Wiley Periodicals, Inc.