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Background: The published experience concerning autologous peripheral blood stem cell collection in children is very limited. Methods: The data of pediatric patients who underwent autologous stem cell mobilization and apheresis between January 2011 and April 2020 were analyzed retrospectively. Results: We studied retrospectively 64 mobilization and apheresis procedures in 48 pediatric patients (34 males, 14 females), mean age of 7.31 ± 5.38 (range, 1.5–19.7) years, the underlying disease was mostly neuroblastoma (NBL). The body weight of 21 patients (43.75%) was 15 kg or less. The targeted autologous peripheral stem cell apheresis (APSCA) was successfully achieved in 98% of patients. Neuroblastoma patients were younger than the rest of the patients and underwent apheresis after receiving fewer chemotherapy cycles than others and all of them mobilized within the first session successfully. Plerixafor was added to mobilization in nine heavily pretreated patients (18.7%), median two doses (range, 1–4 doses). 11 patients (22.9%) underwent radiotherapy (RT) before mobilization with doses of median 24 Gy (range, 10.8–54.0 Gy). Patients with RT were older at the time of apheresis and had received more chemotherapy courses than patients without RT. As a result, patients with a history of RT had significantly lower peripheral CD34+ cells and CD34+ yields than those without RT. In 17 patients (35.4%), 22 different complications were noted. The most common complications were catheter‐related infections (n:10, 20.8%), followed by catheter‐related thrombosis in eight patients (16.7%). Conclusions: Patients who had far less therapy before apheresis were more likely to mobilize successfully. Our study provides a detailed practice approach including complications during APSCA aiming to increase the success rates of apheresis in transplantation centers. [ABSTRACT FROM AUTHOR]

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Background: We aimed to evaluate our pediatric HSCT recipients routinely monitored for adenoviremia and to determine the adequacy of this monitoring in predicting adenoviral disease (AD). Methods: A retrospective cohort of patients who underwent allogeneic HSCT between January 2021 and August 2022, and routinely monitored for adenoviremia by real‐time PCR was included in our survey. Demographic and clinical data of the patients were recorded. Incidence rates, risk factors, and mortality rates related to adenoviremia, and AD were analyzed. Results: Among 104 HSCTs performed in 94 patients adenovirus (AdV) was revealed in 27 (26%) episodes and adenoviremia in 18 (17.3%) HSCT episodes. AD without adenoviremia developed in nine episodes (8.6%). Disseminated disease was significantly more frequently detected in episodes with adenoviremia (p =.008). GVHD was independent risk factor for AdV detection (OR: 8.6, 95% CI: 2.03–33.7, p =.001). Viremia developed within a shorter time interval after HSCT in isolated episodes of adenoviremia compared to those with concomitant AD (p =.006). Initial and peak viral loads were significantly higher in adenoviremia with AD (p <.001). Mortality was higher in the AdV‐detected episodes (p <.001) than in the AdV‐undetected episodes. AdV‐related mortality was found to be 22.2%. Adenoviremia increased the risk of mortality (OR: 1.2, 95% CI: 0.22–1.33, p =.01). Conclusions: Adenoviremia monitoring is an important process in the detection of AD. Since some patients may develop AD without accompanying by adenoviremia, monitoring for AdV in blood samples should be supported with other monitoring methods in order to evaluate the probable involvement of different organs or systems. [ABSTRACT FROM AUTHOR]

Objective: Hematopoietic stem cell transplantation is recommended as a first-line treatment in a pediatric severe aplastic anemia, if the patient has an HLA-matched family donor. In this study, we aimed to evaluate the allogeneic hematopoietic stem cell transplantation outcomes of our patients who were followed with a diagnosis of aplastic anemia. Material and Methods: From April 2010 to July 2017, 10 pediatric acquired aplastic anemia patients treated with allogeneic hematopoietic stem cell transplantation at our center were evaluated retrospectively from patient charts and computer records. Results: A total of 12 allogeneic stem cell transplantations had been performed in 10 patients with severe and very severe acquired aplastic anemia. Mean age during transplantation was 10.9±3.76 (min=4.6-max=16.1) years and 80% of the patients were female. Mean interval from diagnosis to transplantation was 10.1±7.65 (min=3-max=31) months and all of the donors were siblings. The mean nucleated cell count was 4.69±2.17x108 (min=1.13x108-max=8.43x108) and CD34+ cell count was 3.25±1.39x106 (min=1.65x106-max=6.55x106). Mean neutrophil engraftment time was 16.2±0.8 (min=15-max=17) days and platelet engraftment time was 26±6.5 (min=16-max=37) days. Acute graft versus host disease was not observed in any patient and limited chronic pulmonary graft versus host disease was seen in only one patient. Primary graft failure developed in one patient and secondary graft failure in another patient. None of the patients developed myelodysplastic syndrome (MDS), leukemia, paroxysmal nocturnal hemoglobinuria (PNH) or secondary malignancy during follow-up. One patient died due to intracranial hemorrhage on day +16 after transplantation. Mixed chimerism was present in 66.7% and all patients are now followed up with complete hematological remission. Conclusion: We achieved 90% overall survival in our patients over a 7-year follow-up period. Considering the high rates of relapse and clonal hematopoiesis after immünosuppressive treatment in studies reported in the literature, we believe that allogeneic hematopoietic stem cell transplantation can be used as a first-line treatment in children with aplastic anemia, especially if there is an HLA-compatible family donor. [ABSTRACT FROM AUTHOR]