Analysis of Autologous Peripheral Blood Stem Cell Transplantation on Malignant Tumors in Children

Objective To summarize the data of autologous peripheral stem cell transplantation(APBSCT) for treating malignant tumors in 26 Chinese children. Methods From January 1989 and June 2003, 26 patients including 11 acute lymphoblastic leukemia(ALL),3 acute myeloid leukemia,7 malignant lymphoma and 5 neuroblastoma were treated with myeloablative high-dose therapy followed by APBSCT after complete remission(CR) or partial remission(PC). The median time from diagnosis to transplantation was 12 months (ranged from 6 to 64 months). At the time of transplant, 24 patients were in CR, and 2 in PR. Mobilization of stem cells was performed with chemotherapy plus rhG-CSF or rhGM-CSF in 18 patients, and chemotherapy alone in 8 patients. The conditioning regimen consisted of cyclophosphamide plus TBI as basic program in 19 patients, melphalan plus etoposide and carboplatin in four, and busulfan plus melphalan in three. Results The median time of WBC (0 5×10 9/L, or 1 0×10 9/L) and thrombocyte (20×10 9/L) were 12 (8-20), 17(10-28) and 21 days (7-78), respectively. The average follow-up period was 7 3 years(ranged from 1 month to 14 years). The overall survival (OS) and death rates after transplantation were 70%(18/26) and 30%(8/26) respectively. Transplant-related mortality was 7 7%(2/26). Conclusion The combination of chemotherapy and G-CSF is an effective and low toxicity protocol for the mobilization of peripheral blood stem cells. APBSCT can be safely performed in children with malignant tumors.