Rapid and Complete Hematopoietic Reconstitution following Peripheral Blood Stem Cell Autotransplantation in a Child with T Cell Acute Lymphoblastic Leukemia

Abstract

Rapid and complete hematopoietic reconstitution was achieved in a child with T cell acute lymphoblastic leukemia who was autografted with peripheral blood stem cells (PBSC). A large number of PBSC was collected by two courses of 3∼4 hour-lasting lymphopheresis during early remission induced by the second-line chemotherapy and then cryopreserved in liquid nitrogen. A myeloid progenitor cell dose of 203×10⁴ CFU-GM/kg body weight was reinfused to the patient followiog marrow-ablative chemotherapy (MCNU 600 mg/m², cytosine arabinoside 6 g/m², etoposide 300 mg/m², cyclophosphamide 160 mg/kg). Neutrophil count reached 0.5×10⁹/l by day+7 and platelet count reached 20×10⁹/l by day+9. Thereafter, white blood cell count continued to increase and reached a maximum of 38×10⁹/l on day+14. Thus, the rapid recovery of hematopoiesis minimised marrow aplasia-related risks. This approach of stem cell rescue operation can be applied to the treatment of children with cancer, who otherwise have no hope to be cured, as an alternative to bone marrow transplantation.