Mobilized peripheral blood stem cell apheresis via Hickman catheter in pediatric patients. Issue 3 (4th January 2019)

• Record Type: Journal Article
• Authors: Doberschuetz, Nora; Soerensen, Jan; Bonig, Halvard; Willasch, Andre; Rettinger, Eva; Pfirrmann, Verena; Salzmann‐Manrique, Emilia; Schäfer, Richard; Klingebiel, Thomas; Bader, Peter; Jarisch, Andrea
• Is Part Of: Transfusion. Volume 59:Issue 3(2019)
• Page Start: 1061
• Page End: 1068
• Publication Date: 2019-01-04
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.15113
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract : BACKGROUND: Autologous stem cell transplantation remains an integral treatment tool for certain childhood malignancies. In children, a central venous catheter is typically necessary to provide adequate flow rates for preparative apheresis. In this study, the feasibility and efficiency of collecting CD34+ cells via an indwelling Hickman catheter, preimplanted for chemotherapy, instead of placing an additional temporary central venous catheter was evaluated. STUDY DESIGN AND METHODS: Forty‐eight pediatric leukaphereses for autologous hematopoietic stem cell transplantation using Spectra Optia MNC, Version 3.0 were reviewed. We compared preimplanted Hickman catheters with a temporary Shaldon catheter, inserted for apheresis. Apheresis was considered successful if a dose of 2 × 10 6 CD34+ peripheral blood stem cells/kg BW was achieved. RESULTS: In 43 (89.6%) of the 48 patients, a Hickman catheter was used for leukapheresis. Only 5 patients (10.4%) received a temporary Shaldon catheter. In both groups, apheresis was performed without apparent adverse reactions. The dose of collected CD34+ peripheral blood stem cells was 12.7 × 10 6 (range, 2.3–70.7 × 10 6 ) cells/kg BW in the Hickman group and 16.2 × 10 6 (range, 3.8–48.4 × 10 6 ) cells/kg BW in the Shaldon group, showing no statistically significant difference (p = 0.58). In both groups, the primary endpoint of a minimal CD34+ cell concentration of 2 × 10 6 cells/kg BW was achieved at a maximum of two leukapheresis sessions. Apheresis efficacy was further confirmed by the collection efficiency of 40.2% in the Hickman group and 27.8% in the Shaldon group (p = 0.32). CONCLUSION: These data indicate the reliable feasibility and efficacy of mobilized apheresis via an indwelling Hickman catheter. In light of this, the routine insertion of a dialysis catheter for the purpose of leukapheresis should be critically reconsidered.