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KMID : 0387820030100020214
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Clinical Pediatric Hematology-Oncology
2003 Volume.10 No. 2 p.214 ~ p.222
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Allogeneic Peripheral Blood Stem Cell Transplantation from An HLA-identical Sibling Donor in Children
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Yoo Keon-Hee
Min Kee-Woon
Lee Soo-Hyun
Sung Ki-Woong
Kim Dae-Won
Cho Eun-Joo
Koo Hong-Hoe
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Abstract
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Purpose: G-CSF-mobilized peripheral blood is one of the sources of allogeneic hematopoietic stem cells. We report our experiences on allogeneic peripheral blood stem cell transplantation (allo-PBSCT) from an HLA-identical sibling donor in children.
Methods: From August 1998 to January 2003, 8 patients underwent allo-PBSCT. Median age of recipients and donors were 4 yr 10 mo (range 3 yr 2 mo 15 yr) and 5 yr 1 mo (range 1 yr 11 mo 19 yr 8 mo), respectively. Seven patients (3 ALL, 2 neuroblastomas, 1 AML, 1 Gaucher disease) had failed from previous allogeneic or autologous transplant and 1 patient had refractory acute biphenotypic leukemia. Only 2 patients were in complete remission at allo-PBSCT. G-CSF 10mug/kg/day was injected subcutaneously to the donor for 5 days and large volume leukapheresis was performed on 4th and 5th days.
Results: Median number of CD34 and CD3 cells infused was 18.55 106(range 9.47 84.76)/kg and 8.26 108(range 0.88 24.58)/kg, respectively. All patients achieved ANC > 0.5 109/L after a median of 9 days and 6 patients eventually achieved platelet engraftment. There was no grade II-IV acute GVHD but limited chronic GVHD developed in 6 evaluable patients. There was no CMV antigenemia. Three patients died from either transplant-related mortality (n=2) or relapse (n=1). The remaining 5 patients are alive disease-free for 7, 8, 15, 16, and 19 months from allo-PBSCT, respectively.
Conclusion: Our results suggest that mega-dose allo-PBSCT from an HLA-identical sibling donor is expected to improve transplant outcome especially in very high risk pediatric patients.
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KEYWORD
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Allogeneic Peripheral Blood Stem Cell Transplantation, HLA-identical Sibling Donor, Children, Large volume leukapheresis, Mega-dose
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