This information explains autologous peripheral blood stem cell harvesting.
Before you have your autologous stem cell transplant, you will have a procedure called peripheral blood stem cell harvesting. During this procedure, your stem cells are harvested (collected) from your body and then frozen. Stem cells are immature cells that produce all of the blood cells in your body—the white blood cells that fight infection, red blood cells that carry oxygen, and platelets that stop you from bleeding.
After your stem cells are harvested, you will receive a very high dose of chemotherapy to kill any remaining cancer cells in your body. This chemotherapy will also destroy most of the blood cells in your bone marrow and bloodstream.
Harvesting your stem cells beforehand allows us to give you this high dose of chemotherapy. Once we return your stem cells to you on the day of your transplant, they will slowly start to grow, mature, and replace the destroyed cells. You are literally receiving a stem cell transplant “from yourself.”
Before Your Procedure
To increase the amount of stem cells in your bloodstream, you’ll be given injections of a medication called granulocyte colony-stimulating factor (GCSF). GCSF stimulates your body to make more stem cells than usual and encourages the stem cells to move into your bloodstream, where they can be collected much more easily. This process is called mobilization. GCSF drugs include filgrastim (Neupogen®), pegfilgrastim (Neulasta®), and plerixafor (Mozobil®).
In most cases, GCSF injections are self-administered, meaning that you will inject yourself with the medication at home. You’ll be given GCSF in prefilled syringes, which you’ll keep in your refrigerator. Your nurse will give you a resource called Giving Yourself an Injection of Filgrastim (Neupogen®) or Pegfilgrastim (Neulasta®) With a Prefilled Syringe and will go over this information with you.
Central venous catheter
Before your procedure, a nurse or doctor will examine your veins to see if they are healthy enough for the procedure. If your veins are not healthy enough, you will have a central venous catheter (CVC) inserted into a large vein in your collarbone. The catheter will be used during the harvesting procedure and will remain in place for several weeks or months. It will also be used to take samples of your blood and to give you intravenous (IV) fluids and medications.
After your CVC is placed, your nurse will teach you how to care for it and will give you written information.
The Day of Your Procedure
You should eat dairy products and other foods that are rich in calcium the night before and the morning of your harvesting session. Wear comfortable clothes.
The harvesting procedure is done in the Blood Donor Room. The Blood Donor Room is located at:
MSK Schwartz Building Lobby
1250 First Avenue (between East 67th and East 68th Streets)
New York, NY 10065
You will have 3 to 5 harvesting sessions to collect enough cells. The exact number of sessions is determined by the number of stem cells that are collected in each session. You will be notified each day if you need to return for another harvesting session. Each session will last 3 to 4 hours.
During Your Procedure
You will be lying in a bed or sitting in a reclining chair. You will be connected to a machine either by IV tubes in your arms or by your CVC. Blood will be withdrawn through the IV line or CVC and circulated through a machine that collects your stem cells. The rest of your blood will be returned to you.
If you wish, you can watch TV or read during your procedure. A family member or friend may sit with you. Since patients sometimes complain of feeling cold during the procedure, blankets will be available.
After Your Procedure
After your procedure, a dressing will be applied to your arm to prevent bleeding. It should remain in place for at least 3 hours, but not more than 5 hours. If your CVC was used, it will be flushed and recapped.
Your stem cells will be brought to our stem cell laboratory, where they’ll be frozen and stored safely until your transplant day.
After harvesting, most people have minimal side effects and can resume their regular activities. The most common side effects are fatigue and bruising at the needle insertion site.
Call your doctor if you:
- Develop a temperature of 100.4° F (38° C) or higher
- Develop flu-like symptoms
- Notice any redness, bleeding, drainage, or pain at your catheter or needle insertion site
- Notice numbness or tingling in your lips, hands, or feet
- Notice significant pain on the left side of your body