Autologous hematopoietic stem cell transplant (HSCT), characterized by high intensity chemotherapy followed by the infusion of HSC previously collected from the peripheral blood, is a procedure used in the treatment of several malignancies. In pediatrics, the apheresis procedure represents a challenge, due to the need for insertion of a rigid central venous catheter (CVC) in small children. The CVC is usually used for stem cell collection and then removed. Later, the patient will need a new device for cell infusion. We propose the use of one single catheter for both apheresis and infusion. We present five children between 1 and 13 years of age who underwent apheresis using a high flow PICC catheter surgically inserted. All patients utilized a PICC line double lumen 5Fr (PowerPICC™ 5Fr DL BARD/USA) placed in the brachiocephalic vein tunneled on the chest, inserted under 24 h prior to apheresis to assure the devices were pervious. Three of the patients were diagnosed with solid tumor and one with acute lymphoblastic leukemia (ALL) awaiting Car-T Cell therapy. The four children who underwent autologous HSCT used the same catheter for cell infusion and remained with the catheter following discharge. The child who was submitted for Car-T Cell still awaits infusion and the catheter was removed. High flow PICC is a viable alternative for apheresis to maintain an adequate flow of 5 ml/s and can be used as a single catheter throughout the HSCT process, reducing the risks from anesthesia and the catheter insertion procedure. Clinical Research.

中文翻译：

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使用高流量 PICC 导管进行干细胞和淋巴细胞分离术：巴西儿科肿瘤中心的初步经验

自体造血干细胞移植 (HSCT) 的特点是高强度化疗，然后输注先前从外周血中收集的 HSC，是一种用于治疗多种恶性肿瘤的手术。在儿科领域，由于需要在幼儿中插入坚硬的中心静脉导管 (CVC)，因此血浆分离术是一项挑战。 CVC通常用于干细胞采集，然后取出。之后，患者将需要新的细胞输注设备。我们建议使用一根导管进行血浆分离术和输注。我们介绍了 5 名 1 至 13 岁的儿童，他们使用手术插入的高流量 PICC 导管进行了血浆分离术。所有患者均使用 PICC 线双腔 5Fr (PowerPICC™ 5Fr DL BARD/USA) 放置在胸部隧道的头臂静脉中，在血浆分离术前 24 小时内插入，以确保装置可渗透。其中三名患者被诊断患有实体瘤，一名患者被诊断患有急性淋巴细胞白血病（ALL），正在等待 Car-T 细胞治疗。接受自体 HSCT 的四名儿童使用同一导管进行细胞输注，并在出院后仍保留该导管。接受 Car-T 细胞治疗的孩子仍在等待输注，导管已被移除。高流量 PICC 是单采术的可行替代方案，可维持 5 ml/s 的足够流量，并且可在整个 HSCT 过程中用作单根导管，从而降低麻醉和导管插入过程的风险。临床研究。