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Allogeneic Transplants

Allogeneic peripheral blood stem cell transplantation (PBSCT) from HLA-identical sibling donors in children with hematological diseases: a single center pilot study

Bone Marrow Transplantation volume 28, pages 537–543 (2001)Cite this article

Abstract

Between February 1995 and July 1999 25 pediatric patients (8 months to 14 years old) underwent peripheral blood stem cell transplantation (PBSCT) from an HLA-identical sibling donor. Diagnoses included ALL (17), non-ALL (6), and non-malignant disease (2). GVHD prophylaxis consisted of cyclosporine plus methotrexate (15), only cyclosporine (8), cyclosporine plus prednisone (1), or nothing (1). All donors (6 months to 41 years old) received G-CSF at 10 μg/kg/day subcutaneously for 4–5 days and on day 5 underwent large volume leukapheresis. Median number of CD34+ and CD3+ cells collected and infused was 6.9 × 106 (range 2.5–32.8) and 4.5 × 108 (0.5–22.1) per kg of recipient body weight respectively. Median time to achieve ANC >0.5 × 109/l and platelets >20 × 109/l was 10 and 12 days, respectively. Acute GVHD grade ⩾II developed in 10 of 24 evaluable patients (42%). Probability of acute GVHD was 62%. Median time to discharge was 25 days (range 14–52). Among 20 evaluable patients, five (25%) developed chronic GVHD at day 100. Probability of chronic GVHD was 29% after 1 year post PBSC. At a median follow-up of 558 (9–2071) days, overall survival for the whole group is 68%. Probabilities of event-free survival, overall survival and relapse for patients with malignant hematological diseases are 53%, 59% and 24% at 5 years, respectively. This study has confirmed the feasibility and safety of mobilization and collection of PBSC products and the applicability of this procedure to the pediatric population, both donors and recipients. Studies including larger numbers of pediatric patients undergoing allogeneic PBSCT are warranted to determine the long-term outcomes of such procedures. Bone Marrow Transplantation (2001) 28, 537–543.

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References

  1. Dreger P, Suttorp M, Haferlach T et al. Allogeneic granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells for treatment of engraftment failure after bone marrow transplantation Blood 1993 81: 1404–1407

    CAS  PubMed  Google Scholar 

  2. Korbling M, Przepiorka D, Huh YO et al. Allogeneic blood stem cell transplantation for refractory leukemia and lymphoma: potential advantage of blood over bone marrow allografts Blood 1995 85: 1659–1665

    CAS  PubMed  Google Scholar 

  3. Russell JA, Bowen T, Brown C et al. Second allogeneic transplants for leukemia using blood instead of bone marrow as a source of hemopoietic cells Bone Marrow Transplant 1996 18: 501–505

    CAS  PubMed  Google Scholar 

  4. Zecca M, Perotti C, Marradi P et al. Recombinant human G-CSF-mobilized peripheral blood stem cells for second allogeneic transplant after bone marrow graft rejection in children Br J Haematol 1996 92: 432–434

    Article  CAS  PubMed  Google Scholar 

  5. Bensinger WI, Clift T, Martin P et al. Allogeneic peripheral blood stem cell transplantation in patients with advanced hematologic malignancies: a retrospective comparison with bone marrow Blood 1996 88: 2794–2800

    CAS  PubMed  Google Scholar 

  6. Russell J, Brown C, Bowen T et al. Allogeneic blood cell transplants for hematological malignancy: preliminary comparison of outcomes with bone marrow transplantation Bone Marrow Transplant 1996 17: 703–708

    CAS  PubMed  Google Scholar 

  7. Schmitz N, Bacigalupo A, Labopin M et al. Transplantation of peripheral blood progenitor cells from HLA-identical sibling donors. European Group for Blood and Bone Marrow Transplantation (EBMT) Br J Haematol 1996 95: 715–723

    Article  CAS  PubMed  Google Scholar 

  8. Korbling M, Mirza N, Przepiorka D et al. Clinical outcome in 112 patients following HLA-identical allogeneic peripheral blood stem cell (PBSC) Blood 1997 10: (Suppl. 1) 224a–225a

    Google Scholar 

  9. Storek J, Gooley T, Siadak M et al. Allogeneic peripheral blood stem cell transplantation may be associated with a high risk of chronic graft-versus-host disease Blood 1997 90: 4705–4709

    CAS  PubMed  Google Scholar 

  10. Miflin G, Russell NH, Hutchinson RM et al. Allogeneic peripheral blood stem cell transplantation for hematological malignancies: an analysis of kinetics of engraftment and GVHD risk Bone Marrow Transplant 1997 19: 9–13

    Article  CAS  PubMed  Google Scholar 

  11. Vigorito AC, Azevedo WM, Marques JF et al. A randomised prospective comparison of allogeneic bone marrow and peripheral blood progenitor cell transplantation in the treatment of haematological malignancies Bone Marrow Transplant 1998 22: 1145–1151

    Article  CAS  PubMed  Google Scholar 

  12. Solano C, Martinez C, Brunett S et al. Chronic graft-versus-host disease after allogeneic peripheral blood progenitor cell or bone marrow transplantation from matched related donors. A case–control study. Spanish Group of Allo-PBT Bone Marrow Transplant 1998 22: 1129–1135

    Article  CAS  PubMed  Google Scholar 

  13. Brown RA, Adkins D, Khoury H et al. Long-term follow-up of high-risk allogeneic peripheral-blood stem-cell transplant recipients: graft-versus-host disease and transplant-related mortality J Clin Oncol 1999 17: 806–812

    Article  CAS  PubMed  Google Scholar 

  14. Snowden JA, Nivison-Smith I, Atkinson K et al. Allogeneic PBPC transplantation: an effect on incidence and distribution of chronic graft-versus-host disease without long-term survival benefit? Bone Marrow Transplant 2000 25: 119–121

    Article  CAS  PubMed  Google Scholar 

  15. Champlin RE, Schmitz N, Horowitz MM et al. Blood stem cells compared with bone marrow as a source of hematopoietic cells for allogeneic transplantation. IBMTR Histocompatibility and Stem Sources Working Committee and the European Group for Blood and Bone Marrow Transplantation (EBMT) Blood 2000 95: 3702–3709

    CAS  PubMed  Google Scholar 

  16. Bensinger WI, Martin PJ, Storer B et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers New Engl J Med 2001 344: 175–181

    Article  CAS  PubMed  Google Scholar 

  17. Korbling M, Chan KW, Anderlini P et al. Allogeneic peripheral blood stem cell transplantation using normal patient-related pediatric donors Bone Marrow Transplant 1996 18: 885–890

    CAS  PubMed  Google Scholar 

  18. Li CK, Yuen PMP, Chik KW et al. Allogeneic peripheral blood stem cell transplant in children Med Ped Oncol 1998 30: 147–151

    Article  CAS  Google Scholar 

  19. Kawano Y, Watanabe T, Takaue Y . Mobilization/harvest and transplantation with blood stem cells, manipulated or unmanipulated Pediat Transplant 1999 3: (Suppl. 1) 65–71

    Article  Google Scholar 

  20. Watanabe T, Kajiume T, Abe T et al. Allogeneic peripheral blood stem cell transplantation in children with hematological malignancies from HLA-matched siblings Med Ped Oncol 2000 34: 171–176

    Article  CAS  Google Scholar 

  21. Levine JE, Wiley J, Kletzel M et al. Cytokine-mobilized allogeneic peripheral blood stem cell transplants in children result in rapid engraftment and a high incidence of chronic GVHD Bone Marrow Transplant 2000 25: 13–18

    Article  CAS  PubMed  Google Scholar 

  22. Diaz MA, Alegre A, Villa M, Benito A et al. Allogeneic peripheral blood progenitor cell (PBPC) transplantation in children with haematological malignancies Br J Haematol 1997 96: 161–164

    Article  CAS  PubMed  Google Scholar 

  23. Kawano Y, Takaue Y, Watanabe T et al. Efficacy of the mobilization of peripheral blood stem cells by granulocyte colony-stimulating factor in pediatric donors Cancer Res 1999 59: 3321–3324

    CAS  PubMed  Google Scholar 

  24. Lee V, Li CK, Chik MMK et al. Single vs twice daily G-CSF dose for peripheral blood stem cells harvest in normal donors and children with non-malignant diseases Bone Marrow Transplant 2000 25: 931–935

    Article  CAS  PubMed  Google Scholar 

  25. De la Rubia J, Martinez C, Solano C et al. Administration of recombinant human granulocyte colony-stimulating factor to normal donors: results of the Spanish National Donor Registry Bone Marrow Transplant 1999 24: 723–728

    Article  CAS  PubMed  Google Scholar 

  26. De la Rubia J, Diaz MA, Verdeguer A et al. Donor age-related differences in PBPC mobilization with rHuG-CSF Transfusion 2001 41: 201–205

    Article  CAS  PubMed  Google Scholar 

  27. Dreger P, Haferlach T, Echstein V et al. G-CSF mobilized peripheral blood progenitor cells for allogeneic transplantation: safety, kinetics of mobilization and composition of the graft Br J Haematol 1994 87: 609–613

    Article  CAS  PubMed  Google Scholar 

  28. Mifflin G, Charley C, Stainer C et al. Stem cell mobilization in normal donors for allogeneic transplantation: analysis of safety and factors affecting efficacy Br J Haematol 1996 95: 345–348

    Article  Google Scholar 

  29. Anderlini P, Przepiorka D, Champling R, Korbling M . Biologic and clinical effects of granulocyte colony-stimulating factor in normal individuals Blood 1996 88: 2819–2825

    CAS  PubMed  Google Scholar 

  30. Stroncek DF, Clay ME, Herr G et al. Blood counts in healthy donors 1 year after the collection of granulocyte-colony-stimulating factor-mobilized progenitor cells and the results of a second mobilization and collection Transfusion 1997 37: 304–308

    Article  CAS  PubMed  Google Scholar 

  31. Cavallaro AM, Lilleby K, Majolino I et al. Three to six year follow-up of normal donors who received recombinant human granulocyte colony-stimulating factor Bone Marrow Transplant 2000 25: 85–89

    Article  CAS  PubMed  Google Scholar 

  32. Demeocq F, Kanold J, Chassagne J et al. Successful blood stem cell collection and transplant in children weighing less than 25 kg Bone Marrow Transplant 1994 13: 43–50

    CAS  PubMed  Google Scholar 

  33. Takaue Y, Kawano Y, Abe T et al. Collection and transplantation of peripheral blood stem cells in very small children weighing 20 kg or less Blood 1995 86: 372–380

    CAS  PubMed  Google Scholar 

  34. Diaz MA, Alegre A, Benito A et al. Peripheral blood progenitor cell collection by large-volume leukapheresis in low-weight children J Hematother 1998 7: 63–68

    Article  CAS  PubMed  Google Scholar 

  35. Gonzalez M, Benito A, Diaz MA, Madero L . Peripheral blood progenitor cell (PBPC) collection by large-volume leukapheresis from pediatric donors Bone Marrow Transplant 1999 23: 631–633

    Article  CAS  PubMed  Google Scholar 

  36. Diaz MA, Alegre A, Villa M et al. Pediatric experience with autologous peripheral blood progenitor cell transplantation: influence of CD34+ cell dose in engraftment kinetics Bone Marrow Transplant 1996 18: 699–703

    CAS  PubMed  Google Scholar 

  37. Torrelo A, Madero L, Mediero IG, Zambrano A . A cutaneous eruption from G-CSF in a healthy donor Pediat Dermatol 2000 17: 205–207

    Article  CAS  Google Scholar 

  38. Seldinger SI . Catheter placement of the needle in percutaneous arteriography Acta Radiol 1953 39: 368–376

    Article  CAS  PubMed  Google Scholar 

  39. Madero L, Diaz MA, Benito A et al. Non-tunneled catheters for the collection and transplantation of peripheral blood stem cells in children Bone Marrow Transplant 1997 20: 53–56

    Article  CAS  PubMed  Google Scholar 

  40. Kobbe G, Soehngen D, Heyll A et al. Large volume leukapheresis maximizes the progenitor cell yield for allogeneic peripheral blood progenitor donation J Hematother 1997 6: 125–131

    Article  CAS  PubMed  Google Scholar 

  41. Storb R, Deeg HJ, Whitehead J et al. Methotrexate and cyclosporine compared to cyclosporine alone for prophylaxis of acute graft versus host disease after marrow transplantation for leukemia New Engl J Med 1986 314: 729–735

    Article  CAS  PubMed  Google Scholar 

  42. Deeg HJ, Flowers ME, Leisenring W et al. Cyclosporine (CSP) or CSP plus methylprednisolone for graft-versus-host disease prophylaxis in patients with high risk lymphohemopoietic malignancies: long-term follow-up of a randomized trial Blood 2000 96: 1194–1195

    CAS  PubMed  Google Scholar 

  43. Thomas ED, Storb R, Clift RA et al. Bone-marrow transplantation New Engl J Med 1975 292: 832–843

    Article  CAS  PubMed  Google Scholar 

  44. Thomas ED, Storb R, Clift RA et al. Bone-marrow transplantation New Engl J Med 1975 292: 895–902

    Article  CAS  PubMed  Google Scholar 

  45. Glucksberg H, Storb R, Fefer A et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors Transplantation 1974 18: 295–304

    Article  CAS  PubMed  Google Scholar 

  46. Przepiorka D, Weisdorf D, Martin P et al. 1994 Consensus conference on acute GVHD grading Bone Marrow Transplant 1995 15: 825–828

    CAS  PubMed  Google Scholar 

  47. Shulman HM, Sullivan KM, Weiden PL et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathology study of 20 Seattle patients Am J Med 1980 69: 204–217

    Article  CAS  PubMed  Google Scholar 

  48. Kaplan EL, Meier P . Nonparametric estimation from incomplete observations J Am Stat Assoc 1958 53: 457

    Article  Google Scholar 

  49. Anderlini P, Przepiorka D, Seong D et al. Clinical toxicity and laboratory effects of granulocyte colony-stimulating factor (filgrastrim) mobilization and blood stem cell apheresis from normal donors, and analysis of charge of the procedure Transfusion 1996 36: 590–595

    Article  CAS  PubMed  Google Scholar 

  50. Stroncek DF, Clay ME, Smith J et al. Changes in blood counts after the administration of granulocyte colony-stimulating factor and the collection of peripheral blood stem cells from healthy donors Transfusion 1996 36: 596–600

    Article  CAS  PubMed  Google Scholar 

  51. Majolino I, Cavallaro AM, Bacigalupo A et al. Mobilization and collection of PBSC in healthy donors: a retrospective analysis of the Italian Bone Marrow Transplantation Group (GITMO) Haematologica 1997 82: 47–52

    CAS  PubMed  Google Scholar 

  52. Platzbecker U, Prange-Krex G, Bornhauser M et al. Spleen enlargement in healthy donors during G-CSF mobilization of PBPCs Transfusion 2001 41: 184–189

    Article  CAS  PubMed  Google Scholar 

  53. Kawachi Y, Watanabe A, Uchida T et al. Acute arterial thrombosis due to platelet aggregation in a patient receiving granulocyte colony-stimulating factor Br J Haematol 1996 94: 413–416

    Article  CAS  PubMed  Google Scholar 

  54. Kuroiwa M, Okamura T, Kanaji T et al. Effects of granulocyte colony-stimulating factor on the hemostatic system of healthy volunteers Int J Haematol 1996 63: 311–316

    Article  CAS  Google Scholar 

  55. LeBlanc R, Roy J, Demers C et al. A prospective study of G-CSF effects on hemostasis in allogeneic blood stem cells donors Bone Marrow Transplant 1999 23: 991–996

    Article  CAS  PubMed  Google Scholar 

  56. Buckner CD, Clift RA, Sanders JE et al. Marrow harvesting from normal donors Blood 1984 64: 630–634

    CAS  PubMed  Google Scholar 

  57. Madero L, Gonzalez Vicent M, Ramirez M et al. Clinical and economic comparison of allogeneic peripheral blood progenitor cell and bone marrow transplantation for acute lymphoblastic leukemia in children Bone Marrow Transplant 2000 26: 269–273

    Article  CAS  PubMed  Google Scholar 

  58. Miflin G, Stainer CJ, Carter GI et al. Comparative serial quantitative measurements of chimaerism following unmanipulated allogeneic transplantation of peripheral blood stem cells and bone marrow Br J Haematol 1999 107: 429–440

    Article  CAS  PubMed  Google Scholar 

  59. Nakao S, Zeng W, Yamakazi H et al. Early establishment of hematopoietic chimerism following allogeneic peripheral blood stem cell transplantation in comparison with allogeneic bone marrow transplantation Eur J Haematol 1999 62: 265–270

    Article  CAS  PubMed  Google Scholar 

  60. Glass B, Uharek L, Zeis M et al. Allogeneic peripheral blood progenitor cell transplantation in a murine model: evidence for an improved graft versus leukemia effect Blood 1997 90: 1694–1700

    CAS  PubMed  Google Scholar 

  61. Hartung G, Uharek L, Zeis M et al. Superior antileukemic activity of murine peripheral blood progenitor cell grafts mobilised by G-CSF and stem cell factor compared to G-CSF alone Bone Marrow Transplant 1998 21: (Suppl. 3) 16–20

    Google Scholar 

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Acknowledgements

We would like to thank the nurses of the Niño Jesus Children's Hospital Hemato-Oncology and Pediatric Bone Marrow Transplantation Unit for the professional and humane care that was always provided for patients and their families. AI Benito is the recipient of Grant No. 99/9021 from the Fondo de Investigaciones Sanitarias (FIS), Instituto de Salud Carlos III, Madrid, Spain.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Hematology/Oncology, ‘Niño Jesus’ Children's Hospital, Madrid, Spain

    AI Benito, M Gonzalez-Vicent, V Quintero, L Madero & MA Diaz

  2. Histocompatibility, Regional Transfusion Center, Comunidad Autonoma de Madrid, Spain

    F Garcia, A Balas & JL Vicario

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  1. AI Benito
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Benito, A., Gonzalez-Vicent, M., Garcia, F. et al. Allogeneic peripheral blood stem cell transplantation (PBSCT) from HLA-identical sibling donors in children with hematological diseases: a single center pilot study. Bone Marrow Transplant 28, 537–543 (2001). https://doi.org/10.1038/sj.bmt.1703184

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