Possible Improvement of Yields by Separation of Peripheral Progenitor
Cells
Eckschlager T., Staňková J., Gajdoš P., Kavan P., Kabíčková E., Hrubá A. 1 , Marino I., Koutecký J.
Klinika dětské onkologie 2. LF UK a FN Motol, Praha Ústav hematologie a krevní transfuze, Praha |
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Summary:
With the ever increasing number of autologous transplantations of haematopoietic p rogenitor cells the
problem of collection of these grafts becomes more urgent. Because up to a certain limit the rate of
incorporation correlates with the amount of transplanted progenitors, attempts are made to obtain
grafts with a sufficient number of progenitor cells. Under normal conditions blood contrains only a very
small amount of progenitor cells. Therefore they must be mobilized before blood sampling which is the
most critical moment for obtaining an adequate graft. At the Department of paediatric oncology
mobilization is made most frequently by administration of G-CSF, 10 mg/kg per day, either after
chemotherapy or separately. In patients where a poorer effect of mobilization is assumed, either larger
doses of G-CSF are administered or G-CSF and GM-CSF are combined. If collection of the graft fails,
the subsequent procedure depends on the cause. After unsuccessful mobilization and separation there
are the following possibilities: 1. new mobilization and separation after another series of chemotherapy,
2. new mobilization with a larger dose of G-CSF or a combination of G-CSF and GM-CSF and subsequent largevolume apheresis, 3. bone marrow sampling, 4. to abandon megachemotherapy with
autologous transplantation and select another therapeutic plan.
Key words:
mobilization and collection of peripheral progenitor cells, autologous transplantation of
peripheral progenitor cells in children, large volume separations in children
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