Autologous Stem Cell Transplantation Clinical Trial
Official title:
GCSF Plus Plerixafor as First-line Treatment for Autologous Stem Cells Harvest in Children With Malignant Diseases in Need for High-dose Chemotherapy With Stem Cell Rescue.
Plerixafor has been intensively used in recent years for harvesting autologous stem cells
from lymphoma and myeloma adult patients. Its use is indicated after failure to harvest with
GCSF alone. Nevertheless, in the pediatric population its appliance is less well established
and the indications are less well confirmed .Several disease states and diagnoses may prompt
the anticipation of difficulties in harvesting stem cells using GCSF only. Such patients may
benefit utilizing plerixafor in first-line rather than exhausting the stem cell niche with
GCSF alone and only than go for plerixafor as second-line rescue procedure.
In this study we propose to examine the applicability and feasibility of harvesting
autologous stem cells by means of GCSF + plerixafor in first-line measure for pediatric
patients with specific indications.
Improve and report outcomes of children undergoing peripheral stem and progenitor cell
harvesting applying plerixafor in first-line aphaeresis, including:
Pre-harvesting FACS-derived CD34+ cell number. Number of stem cells harvested. Number of
T-cells harvested. Days of hospitalization.
Procedure related toxicity including:
Infections. Line complications. Other organ toxicities.
Compare outcomes of plerixafor-derived stem and progenitor cells harvesting between
different pediatric oncological diseases, including high-risk neuroblastoma, high-risk brain
tumors, high-risk sarcomas and relapsed lymphomas.
Outcomes to be analyzed:
1. Peripheral blood stem cell content by means of percentage of CD34+ cells, after
conditioning protocol (4 days of 10mcg/kg GCSF per day and one dose of plerixafor
0.24mg/kg 10 hours before collection) and before harvesting.
2. Number of stem cells harvested.
3. Morbidity:
1. Bleeding at the time of catheter placement, during harvesting procedure and post
harvesting.
2. Infections: localized vs. generalized. Type of pathogen isolated.
4. Platelet number and hemoglobin level post harvesting.
5. kidney function.
6. Duration of hospitalization: Evaluation of the time course from the day of
hospitalization for the harvesting to the day of discharge.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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