Background: Autologous stem cell transplantation remains an integral treatment tool for certain childhood malignancies. In children, a central venous catheter is typically necessary to provide adequate flow rates for preparative apheresis. In this study, the feasibility and efficiency of collecting CD34+ cells via an indwelling Hickman catheter, preimplanted for chemotherapy, instead of placing an additional temporary central venous catheter was evaluated.
Study Design And Methods: Forty-eight pediatric leukaphereses for autologous hematopoietic stem cell transplantation using Spectra Optia MNC, Version 3.0 were reviewed. We compared preimplanted Hickman catheters with a temporary Shaldon catheter, inserted for apheresis. Apheresis was considered successful if a dose of 2 × 10 CD34+ peripheral blood stem cells/kg BW was achieved.
Results: In 43 (89.6%) of the 48 patients, a Hickman catheter was used for leukapheresis. Only 5 patients (10.4%) received a temporary Shaldon catheter. In both groups, apheresis was performed without apparent adverse reactions. The dose of collected CD34+ peripheral blood stem cells was 12.7 × 10 (range, 2.3-70.7 × 10 ) cells/kg BW in the Hickman group and 16.2 × 10 (range, 3.8-48.4 × 10 ) cells/kg BW in the Shaldon group, showing no statistically significant difference (p = 0.58). In both groups, the primary endpoint of a minimal CD34+ cell concentration of 2 × 10 cells/kg BW was achieved at a maximum of two leukapheresis sessions. Apheresis efficacy was further confirmed by the collection efficiency of 40.2% in the Hickman group and 27.8% in the Shaldon group (p = 0.32).
Conclusion: These data indicate the reliable feasibility and efficacy of mobilized apheresis via an indwelling Hickman catheter. In light of this, the routine insertion of a dialysis catheter for the purpose of leukapheresis should be critically reconsidered.
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http://dx.doi.org/10.1111/trf.15113 | DOI Listing |
Diagn Microbiol Infect Dis
November 2024
Clinical Laboratory, Saitama Medical University International Medical Center, Saitama, Japan; Department of Laboratory Medicine, Saitama Medical University International Medical Center, Saitama, Japan. Electronic address:
This report describes a 6-year-old boy who developed non-tuberculosis mycobacteria (NTM) catheter-related bloodstream infection (CRBSI) during treatment for B-cell precursor acute lymphoblastic leukemia. A Hickman catheter was inserted before starting treatment. He developed a fever during chemotherapy, and blood culture was drawn from the catheter.
View Article and Find Full Text PDFBMC Med Educ
November 2024
Department of Anesthesiology and Intensive Care, Marmara University Pendik Training and Research Hospital, Fevzi Çakmak Mah. Muhsin Yazıcıoğlu Cad. No:10, Pendik, Istanbul, 34890, Turkey.
Background: Tunneled catheters can be inserted for many reasons, and in most centers, and in most centers it is not clear who should insert these catheters. Some anesthesiologists may not have seen first-hand the insertion of a tunneled catheter during their residency, depending on the policies of the institution. YouTube is one of the most commonly used online platforms for accessing medical information.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
October 2024
Division of Electrophysiology, Texas Health Heart and Vascular Specialists, Fort Worth, Texas, USA.
Introduction: It remains unclear if pacing induced cardiomyopathy (PICM) may be minimized by standard pacing of the right ventricle (RV) at sites other than the RV apex. The purpose of this study is to compare the relative frequency of PICM in a population of patients paced at either the superficial RV mid septum (RVMS) or RV apex (RVA), and other outcomes that may differ between these sites.
Methods And Results: A retrospective evaluation was performed on all patients undergoing pacemaker implantation between 2011 and 2022.
J Indian Assoc Pediatr Surg
July 2024
Department of Pediatric Surgery, Narayana Health, Bengaluru, Karnataka, India.
Background: Tunnelled catheters improve venous access in haematological diseases and malignancies, but are associated with complications. We prospectively analysed the episodes of CABSI and its associated risk factors.
Aims: To study the incidence and risk factors for CABSI in children with tunnelled central venous catheters (both Hickmans and Chemoports).
Pediatr Surg Int
August 2024
Department of Pediatric Surgery, Tohoku University Hospital, Sendai, 980-8574, Japan.
Purpose: Patients with intestinal failure (IF) require long-term parenteral nutrition using central venous catheters (CVCs), which often require replacement. We adopted a less fallible guidewire replacement (GWR) method and verified its effectiveness and validity.
Methods: We enrolled 108 cases that underwent a CVC replacement with "GWR" method with IF at our department between 2013 and 2023.
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