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Response from Kořístek et al

Bone Marrow Transplantation volume 31, page 519 (2003)Cite this article

Peripheral blood stem cells (PBSC) collections in the smallest patients (<10 kg) using continuous leukapheresis are encumbered with particular problems compared with older children or adults. First, veins are often too small for sufficient, but safe, access. Second, it is also important to avoid potential citrate toxicity and to avoid a drop in the hematocrit after initiation of the leukapheresis procedure. Third, blood cell separators are not optimized for flow rates as low those corresponding to very small children which could result in diminished leukapheresis efficiency.

Martin et al describe good experiences with large volume leukapheresis for PBSC collection in children weighing <10 kg. Their approach comprised, in brief, of a 10 F double lumen central catheter, priming of the COBE Spectra disposable AutoPBSC tubing set with blood, and reduction of the ACD ratio with complementary heparin-based anticoagulation. The procedures were well tolerated with no adverse effects and results were encouraging.

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References

  1. Kořístek Z, Štěrba J, Havranová D et al. Technique for PBSC harvesting in children of weight under 10 kg. Bone Marrow Transplant 2002; 29: 57–61.

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  1. Department of Internal Medicine-Hematooncology Masaryk University Hospital Brno, Brno, 20 639 00, Jihlavska, Czech Republic

    Z Kořístek & J Štěrba

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  1. Z Kořístek
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  2. J Štěrba
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Kořístek, Z., Štěrba, J. Response from Kořístek et al. Bone Marrow Transplant 31, 519 (2003). https://doi.org/10.1038/sj.bmt.1703908

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