Results
Out of all the patients in our unit who underwent PBSC mobilization and autologous stem cell harvest, 9 received chemotherapy followed by Peg-GCSF. Male: Female ratio was 3.5:1 and the mean age was 7.7years (range 2-15 years). There were 3 cases of stage 4 Neuroblastoma and one each of metastatic Ewing’s sarcoma, metastatic Germ cell tumor of ovary, recurrent anaplastic Ependymoma, relapsed Wilms tumor, relapsed Osteosarcoma and relapsed Medulloblastoma. The data on demographic profile, diagnosis, mobilisation chemotherapy, harvest details is shown in Table I. The mean time from Peg-GCSF administration to PBSC harvest was 9.7 days (range 8-12 days) and from start of mobilization chemotherapy to PBSC harvest was 12.2 days (range 10-15 days). 2 patients required one dose of GCSF boost the day before harvest. All 9 patients harvested with single apheresis procedure. The median CD34 count at the start of harvest was 203/microliter (range 30-490/microliter). The median CD34 hematopoietic stem cell count collected was 26.9 million/kg (range 4.1-60 million/kg) recipient body-weight. The mean product volume collected was 152ml (range 70-250ml). None of the patients had any major adverse events. The median duration of follow-up for these patient’s post-harvest was 6 months (range 4-38 months).
With regard to the outcome data, 1 patient couldn’t reach autologous HSCT due to progression of disease. Remaining children engrafted after autologous hematopoietic stem cell infusion and all had a brisk engraftment. Neutrophil engraftment occurred at a median of 9.5 days (range 8-12 days) post autologous HSCT; Platelet engraftment occurred at a median of 11.5 days (range 10-23 days) post autologous HSCT. Transplant related mortality was nil. Two children relapsed after autologous HSCT.