All issues > Volume 49(10); 2006

Original Article

Korean J Pediatr. 2006;49(10):1079-1085. Published online October 15, 2006.

Factors affecting hematologic recovery and infection in high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk solid tumor

Jung Hyun JH Lee¹, Bo Lyun BL Lee¹, Soo Hyun SH Lee¹, Keon Hee KH Yoo¹, Ki Woong KW Sung¹, Hye Lim HL Jung¹, Eun Joo EJ Cho¹, Hong Hoe HH Koo¹

¹Department of Pediatrics, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence Ki Woong KW Sung ,Email: kwsped@smc.samsung.co.kr

Abstract

Purpose
: The purpose of this study was to evaluate factors affecting hematologic recovery and infection in high-dose chemotherapy(HDCT) and autologous stem cell transplantation(ASCT) in patients with high-risk solid tumor.
Methods
: From January 2004 to December 2005, 72 HDCTs and ASCTs were applied to children with high-risk solid tumor at Samsung Medical Center. Medical records of these 72 HDCTs and ASCTs were retrospectively analyzed.
Results
: The single most powerful predictor of neutrophil and platelet recovery was the number of transplanted CD34＋ cells. The duration of high fever was significantly longer in young patients, in patients treated with total body irradiation and/or thiotepa, and in patients transplanted with lower CD34＋ cell dose(<2×106/kg). However, the difference in the duration of high fever according to the number of CD34＋ cells was not clinically significant.
Conclusion
: Findings in this study suggest that HDCT and ASCT with low CD34＋ cell dose is clinically feasible despite delayed hematologic recovery, especially at a dose >1×106/kg per transplantation. Therefore, it is important not to defer the appropriate time for HDCT for an additional collection of hematopoietic stem cells if the number of collected CD34＋ cells is >1×106/kg per transplantation.

Keywords :High-dose chemotherapy , Autologous hematopoietic stem cell transplantation , Pediatric solid tumor