Peripheral Blood Stem Transplantation Research Articles

A novel approach for the enumeration of peripheral blood stem cells suitable for transplantation.

Stem cells have the capability to proliferate and differentiate into various cells of the body. Few stem cell sources have been approved for transplantation, among them are the hematopoietic progenitor cells which are progenitors of the myeloid and erythroid lineage in the hematopoietic system, that continually provides mature blood cells during the lifespan of the individual. These well-characterized stem cells are clinically relevant in the treatment of diseases such as breast cancer, leukemias, and congenital immunodeficiencies. Peripheral blood stem transplantation is a standard procedure after its first successful transplantation more than 35 years ago. The minimum intended dose of stem cells given to the patient is 2.5 × 106 –5 × 106 cells. In this study, we are establishing a correlation between the number of stem cells enumerated and the weight of the patient as a determinant for suitable transplantation. We have established a conversion factor to deliver the required dose of approximately 3 × 106 stem cells/kg body weight. This will ensure a uniform collection strategy that is sufficient for transplantation irrespective of the weight of the patient. This approach, if incorporated, will lead to a significantly lesser rate of bone marrow transplantation failures as sufficient number of stem cells will ensure engraftment of stem cells.

Intraabdominal desmoplastic small round cell tumour

Desmoplastic small round cell tumour (DSRCT) is an extremely rare neoplasm. Adolescent males and young adults are most frequently affected. It is highly malignant, with only 29% of patients surviving up to 3 years. This paper documents two cases, one of which, at 4 years old, is the second youngest case documented. Case 1, a 10-year old boy, presented with a 20-day history of choluria, acholia, asthenia, anorexia, and right abdominal pain. Laboratory values were altered, and imaging showed multiples masses in the liver and retroperitoneum. A minilaparotomy was carried out, and a biopsy showed a stage III DSRCT. He was treated with chemotherapy but died of hepatic failure. Case 2, a 4-year-old boy, presented with a 2-month history of abdominal distension. Several hard masses were palpated in the abdomen, and a right inguinal mass that compressed the right testis was observed. Biopsy of the inguinal tumour showed a DSRCT. After treatment with chemotherapy, two operations were carried out to resect different intraabdominal masses. The patient died with peritoneal carcinomatosis 2 months after the last operation. The first patient died due to the advanced stage of the disease, and the second died after chemotherapy, peripheral blood stem transplantation, and multiple operations. The occurrence of this type of tumour in the paediatric age group as well as its high malignancy is noteworthy. Until more effective forms of treatment are found, we recommend treatment with chemotherapy, surgery, and radiotherapy, with close monitoring of the patient.

Precise CD34+ Quantification Using a Multi-Parameter Flow-Cytometric Method with Fluorescent Microparticles

Background: In recent years, peripheral blood stem cell transplantation has replaced autologous bone marrow transplantation to a large extent in patients with hematological malignancies. Optimal timing and adequate harvesting rely upon the precise quantification of mobilized CD34+ cells in blood and apheresis products. The quality assessment of collected stem cells includes viability tests, short-term culture assays and the determination of CD34+ cells by flow cytometry. External quality controls have suggested the urgent need for greater standardization of the enumeration of CD34+ cells. Material and Methods: We evaluated a single-platform assay for CD34+ cell quantification in peripheral blood and leukapheresis samples (n = 22) by using a four-parameter flow-cytometric method (forward and side angle light scatter, CD34 PE, CD45 FITC) including Flow Count fluorospheres for direct quantification. Results: When processing times of 30 and 300 s were compared, the inter-assay coefficients of variation declined significantly from 11% and 12% in peripheral blood and leukapheresis to 4.7% and 5.2% (p = 0.003 and p = 0.016), respectively. The precision analysis of the flow-cytometric method (intra-assay variation) generated coefficients of variation, which dropped from 8.1% and 8.5%, respectively, to 3.3% for both samples with regard to the processing time (p < 0.001). Conclusion: The data demonstrate the need of single-platform flow-cytometric methods based on fluorescent microparticles. They showed a greater precision of CD34+ cell enumeration over the course of analysis time. Because of its clinical relevance in peripheral blood stem transplantation, these improvements should supplement the current guidelines.