Allogeneic Donor Peripheral Blood Stem Cell Harvesting

This information describes the procedure for donating peripheral blood stem cells at Memorial Sloan Kettering (MSK).

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. Peripheral blood is the blood that circulates in your blood vessels, and includes every type of blood cell.

Peripheral stem cell harvesting is the procedure used to collect some of the stem cells in your blood. When stem cells are taken from a donor, it’s called allogeneic peripheral blood stem cell harvesting. These cells will then be given to a patient in a peripheral blood stem cell transplant. The cells that you donate will grow, mature, and replace the patient’s destroyed cells.

Before Your Procedure

Stem cell mobilization and granulocyte colony-stimulating factor injections

There are only a small number of stem cells circulating in your blood. To increase the number of stem cells in your bloodstream, you will receive injections (shots) of a medication called granulocyte colony-stimulating factor (GCSF). GCSF causes your body to make more stem cells than usual. It also encourages the stem cells to move into your bloodstream, where they can be collected more easily. This process is called mobilization. GCSF medications include filgrastim (Neupogen®) and plerixafor (Mozobil®). You will need either filgrastim alone or filgrastim and plerixafor. Your nurse will review which injections you will need.

You can either be taught to do the injections yourself or you can discuss other arrangements with your nurse. If you’re doing the injections yourself, your nurse will give you the resource Giving Yourself an Injection of Filgrastim (Neupogen) or Pegfilgrastim (Neulasta) with a Prefilled Syringe. You must store these medications in the refrigerator. The injections of filgrastim (Neupogen) will be every day for about 5 to 6 days. If you’re asked to take plerixafor, those injections will be every day for 1 to 4 days.

Common side effects of these medications include bone pain in your sternum, arms, legs, and lower back. They can also cause headaches and flu-like symptoms. Either regular or extra strength acetaminophen (Tylenol®) may relieve these side effects. If acetaminophen doesn’t help, your doctor will prescribe something stronger.

Central venous catheter placement

Before we collect your stem cells, a nurse from our donor room will check your veins to make sure that they’re healthy enough for the procedure. If your veins aren’t healthy enough, you will have a central venous catheter (CVC) inserted into a large vein near your collarbone. The CVC will be used during the procedure and will be removed once your collection is complete. Your nurse will teach you how to care for it and will give you written information.

What to eat

As your stem cells are collected, your blood calcium levels may drop. We recommend that you eat dairy products and other foods that are rich in calcium (cheese, milk or ice cream). This will help to raise the calcium levels in your blood.

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The Day of Your Procedure

Where to go

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
212-639-7643

 

You will have appointments 2 days in a row. Each harvesting session usually takes 3 to 4 hours. On these days, you will get the dose of filgrastim at least 1 hour before your appointment.

What to expect

The harvesting is done while you’re on a bed or in a recliner chair. You will be connected to a machine either by IV tubes in your arms or by your CVC. Blood will be drawn through the IV line or CVC and circulate through the machine. The machine will collect your stem cells and 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. You might feel cold during the procedure, so blankets will be available to make you comfortable.

As your stem cells are collected, you may have:

  • Muscle cramps
  • Twitching
  • A tingling sensation around your lips and fingertips

These are signs of low calcium levels in your blood. The staff in the Donor Room will give you calcium carbonate in the form of Tums®, which are a quick and easy source of calcium.

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After Your Procedure

After your procedure, if IV lines were placed in your arm(s), you will have a bandage on your arm to prevent bleeding. Leave the bandage in place for at least 3 hours, but not more than 5 hours. If your CVC was used, it will be flushed and recapped.

If there is bleeding when you remove the bandages, apply gentle but firm pressure on the site(s) for 3 to 5 minutes. Call your doctor if the bleeding doesn’t stop.

Ask your doctor when you an return to your regular activities. Most people can go back to their regular activities the day of or the day after the donation.

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Call Your Doctor If You:

  • Have a temperature of 100.5° F (38° C) or higher
  • Develop flu-like symptoms
  • Have significant pain on the left side of your body
  • Have any of the following symptoms in the areas where the needles were inserted in your arms:
    • Redness
    • Bleeding that doesn’t stop with firm pressure
    • Pain
    • Swelling
 
GCSF Injection Schedule
Medication: ______________________________ Dose: _______________
Date Time Donor Room Appointment
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

GCSF Injection Schedule
Medication: ______________________________ Dose: _______________
Date Time Donor Room Appointment
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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