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J Pediatr Surg ; 59(8): 1600-1604, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38494399

RESUMO

BACKGROUND: 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. AIM: We propose the use of one single catheter for both apheresis and infusion. METHODS: We present five children between 1 and 13 years of age who underwent apheresis using a high flow PICC catheter surgically inserted. RESULTS: 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. CONCLUSIONS: 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. TYPE OF STUDY: Clinical Research.


Assuntos
Cateteres Venosos Centrais , Transplante de Células-Tronco Hematopoéticas , Humanos , Criança , Adolescente , Pré-Escolar , Lactente , Masculino , Transplante de Células-Tronco Hematopoéticas/métodos , Feminino , Brasil , Cateteres Venosos Centrais/efeitos adversos , Remoção de Componentes Sanguíneos/métodos , Remoção de Componentes Sanguíneos/instrumentação , Cateterismo Venoso Central/métodos , Cateterismo Venoso Central/instrumentação , Cateterismo Venoso Central/efeitos adversos , Neoplasias/terapia , Institutos de Câncer , Transplante Autólogo
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