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.