Clinical pearls in pediatric anesthetic considerations for peripheral blood stem cell transplant and lacunae in our current knowledge

Clinical introduction of peripheral blood stem cell transplant (PBSCT) has replaced bone marrow as a stem cell source in 99% autologous and 75% allogeneic transplantation cases. Incompliant pediatric donors require general anesthesia for PBSCT. Whether the CD34-positive (CD34+) stem cell yield from PBSC donor is affected by age, weight, and sex of donor and type/duration of anesthesia is not very clear from the current literature. These factors may have significant clinical implications as is evident from the poor yield (0.11 million/kg CD34+ cells) on the second day of stem cell harvest from our 2-year-old donor.