Non-tunneled catheters for the collection and transplantation of peripheral blood stem cells in children

Abstract

We analyzed the use of non-tunneled (polyurethane, double lumen) central venous catheters (CVCs) for the collection, conditioning, transplantation and immediate post-transplantation periods in 56 children with various malignant diseases. A total of 71 leukaphereses were performed, with a mean of 1.2 apheresis per patient, following administration of granulocyte colony- stimulating factor (G-CSF) using a continuous flow blood cell separator (Cobe Spectra). The mean TBV (total blood volume) processed was 4.5 ± 1.2 s.d. (range 2.4–7). The mean flow rate was 30.6 ml/min and the duration of a single apheresis was 327 ± 84 s.d. (range 175–511 min). The mean purities and efficacies of collections were 77.38 ± s.d. (range 42–100) and 42.78 ± s.d. (range 24–80), respectively. The mean numbers of mononuclear cells (MNC) and CD34⁺ cells collected were 9.3 ± 6.9 s.d. × 10⁸/kg (range 2–49) and 6.2 ± 7.2 s.d. × 10⁶/kg (range 1–42), respectively. We observed the following complications during catheter insertion for collection: pneumothorax (1.7%), mechanical dysfunction (3.5%) that resolved with thrombolytic therapy. Complications during conditioning, transplantation and immediate post-transplantation periods were entry site infection in five patients (8.92%), catheter-related infection in two (3.57%) and catheter-related sepsis in three (5.35%). Our results indicate that the collection of PBSC with non-tunneled catheters is safe, effective and is associated with a low incidence of complications.