Abstract:

BACKGROUND: Autologous peripheral blood stem-cell transplantation (APBSCT) is an important method to treat malignant solid tumor in children. Mobilization and collection of stem cells are the key for hematopoietic reconstitution.
OBJECTIVE: To evaluate the clinical effect of mobilization and collection by cyclophosphamide, doxorubicin and vincristine mobilization chemotherapy program in children with neuroblastom/primitive neuroectodermal tumor (NB/PNET).
METHODS: Protocol of cyclophosphamide, doxorubicin and vincristine mobilization was used as mobilization chemotherapy in 35 cases (including 30 NB and 5 PNET). Effect of stem cell collection was observed.
RESULTS AND CONCLUSION: Leukocytes decreased to less than 2×10⁹/L on 4-9 days (averagely 6.5 days) after the chemotherapy when granulocyte-colony stimulating factor (G-CSF) 5-10 mg/kg was given to stimulate hematopoiesis. Collection began when leukocytes reached to more than 5×10⁹/L on 13-19 days after chemotherapy (averagely 15.5 days). Mononuclear cells and CD34⁺ cells were successfully collected in all cases. Total collection times were 1-4 times, averagely 2.1 times. The volumes of mononuclear cells and CD34+ cells were respectively (6.1±1.2)×10⁸/kg and (5.3±0.8)×10⁶/kg. Trypan blue exclusion rate was 99.5%(99%-100%). No severe complication was observed during the mobilization. All subjects could tolerate. Prompt and sustained hemocytoblastic reconstitution was observed in 25 children. Leukocytes began to increase (neutrophilic granulocytes > 0.5×10⁹/L) at 10-20 days posttransplantation (averagely 14 days). Hemoglobin recovered (> 80 g/L) at 10-30 days posttransplantation (averagely 18 days). Platelet recovered (> 20×10⁹/L) at 12-35 days posttransplantation (averagely 20 days). The program of cyclophosphamide, doxorubicin and vincristine is a highly efficient autologous peripheral blood stem cell mobilization and collection protocol in children with NB/PNET.