Collection and Infusion of Bone Marrow, Peripheral Blood Stem Cells and Umbilical Cord Cells

Abstract Increasing number of patients in China have difficulty of finding sibling donors due to limited number of siblings. We therefore explored the feasibility using haploidentical parent donors for allogeneic hematopoietic stem cell transplantation. Eight leukemia patients were studied in our hospital. These included 2 CML-BC, 2 MDS-RAEB, 3 relapsed ALL and 1 relapsed AML. The median age was 12 (7–17). GCSF- mobilized bone marrow and peripheral blood stem cells were collected from parents (1 to 3 locus mismatched). The conditioning regimen consisted of fludarabine (30mg/m2/d x5), bulsulfan (4mg/kg/d x3) and cyclophosphamide (50mg/kg/d x2). Cyclosporin A, mycophenolate mofetil, methotrexate, and ATG were used for GVHD prophylaxis. The total number of CD34+ cell in the grafts ranged between 5–10 x 106/kg. The median follow- up was 13 months (6–24). One patient failed to engraft, the other 7 patients achieved full donor chimerism at day 28. The incidence of acute GVHD (grade II-IV) was 57.1% (4 of 7). The incidence of chronic GVHD of limited stage occurred in the same 4 patients. One patient died of lung complication at 17th month, another patient with CML-BC relapsed 10 months after transplantation. The rest 6 patients are alive without disease. These results suggested that parents could be considered as stem cell donors in the absence of alternative donors for young patients with high-risk diseases. GCSF-primed bone marrow plus peripheral blood stem cells might be beneficial to reduce the risk of GVHD for leukemia children in China. More patients are needed to further study this approach.

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Allogeneic Haematopoietic Stem Cell Donation — Current Status with Regard to Safety

European Oncology & Haematology ◽

10.17925/eoh.2011.07.03.211 ◽

2011 ◽

Vol 07 (03) ◽

pp. 211

Author(s):

Alberto Bosi ◽

Benedetta Bartolozzi ◽

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Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Stem Cell ◽

Peripheral Blood ◽

Haematopoietic Stem Cell ◽

Current Status ◽

Peripheral Blood Stem Cells ◽

First Choice ◽

Donation Process ◽

Blood Stem Cells

Allogeneic haematopoietic stem cell transplantation (HSCT) represents the first choice of treatment or an important therapeutic option for numerous diseases. Several stem cell sources, such as bone marrow, mobilised peripheral blood stem cells and umbilical cord blood, are suitable for HSCT in clinical practice. However, this procedure is strongly related to availability of a histocompatible donor. In order to increase the probability of finding a histocompatible donor, national and international registries have been developed. Voluntary donation of bone marrow or peripheral blood stem cells for HSCT, both in the related or unrelated setting, is a well-established procedure with an invaluable ethical significance. Even if both procedures are safe, they are not risk free; therefore, the greatest attention has to be paid to the donor and to the donation process through a careful monitoring protocol for donor safety.

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