Mobilization and collection of CD34+ cells for autologous transplantation of peripheral blood hematopoietic progenitor cells in children: analysis of two different granulocyte-colony stimulating factor doses

The use of peripheral hematopoietic progenitor cells (HPCs) is the cell choice in autologous transplantation. The classic dose of granulocyte-colony stimulating factor (G- CSF) for mobilization is a single daily dose of 10 µg/kg of patient body weight. There is a theory that higher doses of granulocyte-colony stimulating factor applied twice daily could increase the number of CD34+ cells collected in fewer leukapheresis procedures. Objective: The aim of this study was to compare a fractionated dose of 15 µg G-CSF/kg of body weight and the conventional dose of granulocyte-colony stimulating factor in respect to the number of leukapheresis procedures required to achieve a minimum collection of 3 × 106 CD34+ cells/kg body weight. Methods: Patients were divided into two groups: Group 10 - patients who received a single daily dose of 10 µg G-CSF/kg body weight and Group 15 - patients who received a fractioned dose of 15 µg G-CSF/kg body weight daily. The leukapheresis procedure was carried out in an automated cell separator. The autologous transplantation was carried out when a minimum number of 3 × 106 CD34+ cells/kg body weight was achieved. Results: Group 10 comprised 39 patients and Group 15 comprised 26 patients. A total of 146 apheresis procedures were performed: 110 (75.3%) for Group 10 and 36 (24.7%) for Group 15. For Group 10, a median of three (range: 1-7) leukapheresis procedures and a mean of 8.89 × 106 CD34+ cells/kg body weight (±9.59) were collected whereas for Group 15 the corresponding values were one (range: 1-3) and 5.29 × 106 cells/kg body weight (±4.95). A statistically significant difference was found in relation to the number of apheresis procedures (p-value <0.0001). Conclusions: To collect a minimum target of 3 × 106 CD34+ cells/kg body weight, the administration of a fractionated dose of 15 µg G-CSF/kg body weight significantly decreased the number of leukapheresis procedures performed.

Micobacteriose Atípica Pós Transplante Alogênico de Medula Ossea / Mycobacteriosis atypical transplant from

Os autores apresentam um raro caso de micobacteriose atípica bem como complicaçöes imunológicas, em um paciente portador de LMC fase crônica submetido a um TMO alogênico com célula-tronco periférica de doador HLA idêntico. Säo discutidas as características clínicas do paciente ao diagnóstico, a terapêutica instituída e as possíveis causas de óbito

Esferocitose hereditária no período neonatal: relato de caso e revisäo de literatura / Hereditary spherocytosis in neonatal period: a case report and literature review

Relatam um caso clínico de esferocitoses hereditária no período neonatal, bem como uma revisäo de literatura. Comentam os aspectos clínicos, laboratoriais, evolutivos e terapêuticos. Destacam, ainda, a importância do diagnóstico diferencial com a doença hemolítica por incompatibilidade ABO.