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Case Reports in Oncological Medicine
Volume 2017, Article ID 4184879, 4 pages
https://doi.org/10.1155/2017/4184879
Case Report

Small Split Doses of CD34+ Peripheral Blood Stem Cells to Support Repeated Cycles of Nonmyeloablative Chemotherapy

1Division of Hematology/Oncology, Department of Pediatrics, Children’s Hospital of Michigan, Wayne State University, 3901 Beaubien Street, Detroit, MI 48201, USA
2Institute for Pediatric Oncology, N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye Shosse, Moscow 115478, Russia

Correspondence should be addressed to Maxim Yankelevich; ude.enyaw.dem@eleknaym

Received 18 May 2017; Revised 6 August 2017; Accepted 25 October 2017; Published 12 November 2017

Academic Editor: Josep M. Ribera

Copyright © 2017 Maxim Yankelevich et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cumulative myelosuppression is the main limiting factor for administration of repeated cycles of chemotherapy. We present a case series of five pediatric patients with high-risk solid malignancies who received small split peripheral blood stem cells (PBSC) doses of less than 1 × 106/kg CD34+ cells obtained after a single leukapheresis procedure and given after repeated cycles of ICE (ifosfamide, carboplatin, and etoposide) chemotherapy. Mean duration to absolute neutrophil count (ANC) recovery to >1000/mm3 and platelet recovery to >50 × 103/mm3 was 17.1 and 24.3 days. Using split doses of PBSC prevented prolonged neutropenia after repeated cycles of submyeloablative chemotherapy.