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Department of Pathology, Microbiology, and Immunology

Transfusion Medicine -Apheresis

 

   Staff

 

Melissa Anderson

 

 

a

Diane
Mathews

     

Mary
Mornout

 

Karen Proctor

     

Jessica Thomashefs

 

 

 

     

   Stem Cell Collection

PROCEDURE: PERIPHERAL BLOOD STEM CELL COLLECTION (PBSC)

Description:

Stem cells are immature cells from the bone marrow that can turn into mature red blood cells, white blood cells, or platelets. Certain medications can be used to increase the number of stem cells in the blood. These stem cells can then be collected from the blood using a machine that separates the blood using a centrifuge. The stem cells are collected into a bag and the rest of the blood is returned to the patient.

Reason for the Procedure:

Many cancer patients require intensive chemotherapy that can destroy their bone marrow and prevent them from creating enough blood cells. The stem cells that are collected can restore the normal cells of the bone marrow.

For healthy donors, medications can be administered to increase the number of immature stem cells in the peripheral circulation.  Using the stem cell collection device, these immature cells can be collected for either immediate transplantation in the recipient or storage for the recipient following chemotherapy treatment.

Venous Access:

Some stem cell collections can be performed using 2 intravenous needles, one in each arm. Blood is removed from one arm, processed in the machine, and returned to the patient through the other arm. In patients with small or fragile peripheral veins, the placement of a central venous catheter may be necessary.

Duration:

A typical procedure lasts approximately 4-6 hours.  Patients should eat a healthy meal prior to arrival in the stem cell collection clinic (2512A The Vanderbilt Clinic TVC).

Risks and Side Effects:

Peripheral blood stem cell collection is a safe procedure but side effects can occur. Common side effects include fatigue, nausea, dizziness, cold feeling, and tingling in the fingers and around the mouth. It is very important to notify medical staff if these symptoms occur. Serious complications, including abnormal heart rate and seizures are extremely rare, but can occur.

Diseases for Which Peripheral Blood Stem Cell Collections are Used:

This procedure is most commonly used for cancers of the blood system, including lymphomas, leukemias and multiple myeloma. It can also be used in other diseases of the immune system.

Number of Procedures that are Required:

The number of procedures will depend on the patient. In most cases, 2-4 stem cell collections are required over a period of 2-4 days. Patients should ask their physicians for specific details pertaining to their condition.

Other Considerations:

Patients should talk to their physicians about any medication adjustments that may be required prior to undergoing the procedure. Many patients who require this procedure have a decreased level of blood platelets. This procedure may decrease the level of platelets even further. Your physician will carefully monitor your blood counts while you are receiving treatment.

   Photopheresis

Description of Procedure:

Photopheresis is a medical procedure in which blood is collected into a specialized machine and separated by centrifugation into white blood cells and the other components of blood. The white blood cells are then treated with a medication called methoxsalen (8-MOP), which makes them sensitive to ultraviolet light. The treated white blood cells are exposed to an ultraviolet light (UVA) inside the machine and returned to the patient.

Rationale for the Procedure:

In certain conditions like Graft Versus Host Disease (GVHD), Cutaneous T-cell Lymphoma or organ transplant rejection, medications alone are often not effective. The addition of photopheresis for these diseases may improve symptoms. It is not known exactly how photopheresis works; it is thought that the procedure changes the activity of the immune system. This alteration of the immune system can help decrease symptoms or treat transplant rejection.

Venous Access:

In some cases photopheresis can be performed using needles that are placed in each arm. The blood is removed from one arm and returned through the other arm. In patients with small or fragile peripheral veins, a central venous catheter may be necessary.

Duration:

The duration of the procedure varies from patient to patient. Generally, this procedure takes 1.5-4 hours to complete.

Risks and Side Effects:

Photopheresis is generally safe and well tolerated, but side effects can occur. Possible side effects include fatigue, decreased blood pressure during the procedure, dizziness, temporary increase in itching, and low grade fever.

Diseases for Which the Procedure is Used:

Photopheresis is used to treat conditions such as Cutaneous T-cell Lymphoma, transplant rejection, and GVHD.

Number of Procedures that are Required:

The number and length of treatments vary depending on the disease being treated, the severity of symptoms, and the response to photopheresis. Your physician will determine your treatment plan. Response to treatment is gradual and can take weeks to months to be noticeable. It is important to continue with treatment.

Other Considerations:

Methoxsalen makes patients more sensitive to sunlight for 24 hours after treatment. It is important to avoid sunlight, wear sunscreen when exposed to sunlight, and wear UVA protective eyewear during this time.

   Videos

 

♦  THERAKOS® CELLEX® Photopheresis System
 

♦  Therakos Cellex: Mechanism of Action
 

   Medication Order Forms

 

♦  Standing Orders/PRN Medication

 

♦  Apheresis Photopheresis NP Daily Order Sheet