Možnosti zlepšení výtěžků separací periferníchprogenitorových buněk – zkušenosti kliniky dětskéonkologie

Possible Improvement of Yields by Separation of Peripheral ProgenitorCells

With the ever increasing number of autologous transplantations of haematopoietic p rogenitor cells theproblem of collection of these grafts becomes more urgent. Because up to a certain limit the rate ofincorporation correlates with the amount of transplanted progenitors, attempts are made to obtaingrafts with a sufficient number of progenitor cells. Under normal conditions blood contrains only a verysmall amount of progenitor cells. Therefore they must be mobilized before blood sampling which is themost critical moment for obtaining an adequate graft. At the Department of paediatric oncologymobilization is made most frequently by administration of G-CSF, 10 mg/kg per day, either afterchemotherapy or separately. In patients where a poorer effect of mobilization is assumed, either largerdoses 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 thereare 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 withautologous transplantation and select another therapeutic plan.

Key words:
mobilization and collection of peripheral progenitor cells, autologous transplantation ofperipheral progenitor cells in children, large volume separations in children