Peripheral Blood Stem Cell Harvest by Transient Radial Arterial Catheterization in Pediatric Patients

Lee, Kye Hyoung; Kim, Moon Kyu; Hong, Chang Ho

Abstract

BACKGROUND: Peripheral blood stem cell transplantation in children has some difficulties compared with adult cases. Despite the children's total blood volume is small, they have a relatively higher volume of blood per weight than adults. Also, it is hard for the children to maintain 2 central vein during leukapheresis to shorten the time consumed. We compared the artery-harvest and central vein-harvested group for possible risk and stem cell yield in pediatric patients with malignancies.
METHODS
From August, 1995 to January, 1997, 21 leukapheresis was performed by 7 patients. The patients who could have 2 central veins for leukapheresis were included in vein-harvested group and the patients who could have only 1 central vein were included in artery-harvested group. The peripheral vein was not used for leukapheresis. COBE Spectra(COBEBCT, Lakewood, CO) was used and priming was done by packed RBCs in patients weighing less than 20kg. Stem cell yield was assessed by MNC, CD34+, CFU-GM, respectively. During leukapheresis, the patients were closely monitored for change in vital sign, evidence for thrombosis, bleeding, hypocalcemia, etc.
RESULTS
There was no serious complication in each group of patients. After the leukapheresis, WBC and platelet count decreased but Hb level was increased due to reinfusion of primed packed RBCs. Average flow rate was higher in vein-harvested group but there was no difference in time consumed and results in stem cell assay.
CONCLUSION
Peripheral stem cell harvest in children by radial artery can be performed safely and easily without an increased risk or complication. In younger children, it is possible to achieve even more higher stem cell yield. If the patient is unable to maintain 2 central vein for leukapheresis, transient radial arterial catheterization is a safe and convenient method.