Autologous Peripheral Blood Stem Cell Harvesting

This information explains autologous peripheral (ah-TOL-o-gus per-IF-er-al) blood stem cell harvesting at Memorial Sloan Kettering (MSK).

Autologous peripheral blood stem cell harvesting is a procedure to harvest (collect) stem cells from your body. 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. Autologous means your own stem cells will be harvested, stored, and given back to you later. Peripheral blood is the blood that circulates in your blood vessels.

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 the chemotherapy is finished, you will receive an autologous stem cell transplant. This means we will return your stem cells to you. Once they are back in your body, the stem cells will slowly start to grow, mature, and replace the destroyed cells.

Before Your Procedure

Mobilization

There is only a small number of stem cells circulating in your blood. To increase the number of stem cells in your bloodstream, you will receive 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®), pegfilgrastim (Neulasta®), and plerixafor (Mozobil®).

Usually, GCSF injections are self-administered, meaning that you will give yourself the shots at home. You will receive GCSF in prefilled syringes, which you will 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.

Common side effects of these mobilization medications include bone pain in your 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 does not help, your doctor will prescribe something stronger.

Central venous catheter placement

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 CVC 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.

What to eat

The night before your harvesting session, eat dairy products and other foods that are rich in calcium. This will help to raise the calcium levels in your blood.

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The Day of Your Procedure

The morning of your harvesting session, eat more dairy products and other foods that are rich in calcium. Remember to wear comfortable clothes for the 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

What to expect

While your stem cells are being harvested, you will lie in a bed or sit 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 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. You can drink milk and eat dairy foods during your procedure. The staff in the Donor Room can also give you calcium carbonate in the form of Tums®, which are a quick and easy source of calcium.

You will have 3 to 5 harvesting sessions to collect enough cells. The exact number of sessions depends on the number of stem cells that are collected in each session. You will be told each day if you need to return for another harvesting session. Each session will last 3 to 4 hours.

 
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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.

Your stem cells will be brought to our stem cell laboratory, where they’ll be frozen and stored safely until your transplant day.

After a harvesting session, most people have minimal side effects and can resume their regular activities. The most common side effects are bruising where the needle was inserted and feeling tired.

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Call Your Doctor if You:

  • Develop a temperature of 100.4° F (38° C) or higher
  • Develop flu-like symptoms
  • Have any redness, bleeding, drainage, or pain at your catheter or needle insertion site
  • Have numbness or tingling in your lips, hands, or feet
  • Have significant pain on the left side of your body
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