What is peripheral blood stem cell (PBSC) collection?
Peripheral blood stem cell (PBSC) collection is a process to take stem cells from blood in the veins (peripheral blood). This process is also called stem cell donation or stem cell harvest.
Stem cells (also called progenitor cells or hematopoietic stem cells) are cells that can develop into other types of cells, such as blood cells. Stem cells for transplant can come from the blood or the bone marrow. Bone marrow is the soft, spongy tissue inside most bones.
A stem cell transplant is a treatment for certain cancers and blood disorders. Stem cells can come from the patient or a donor, a person who donates stem cells to a patient who needs a transplant.
Medicine to increase the number of stem cells in the blood
Stem cell collection from blood through a vein
Before PBSC donation
Screening exam and blood tests
Before stem cell collection, the donor – either the patient or another person - will have a physical exam and blood tests to make sure it is safe to proceed. These tests check for overall health and screen for infections. This step is important because transplant patients have weakened immune systems and cannot fight infections well.
Medicine to increase stem cells (mobilization)
A medicine, called a growth factor, is given to help move stem cells from the bone marrow into the blood. This process is called mobilization.
More than one growth factor medicine may be given. It is usually given as an injection (shot) once a day for a few days. Females of childbearing age must have a pregnancy test before taking growth factors.
Growth factor side effects: Most side effects of growth factors are mild and go away soon after the injections stop. Side effects include:
The care team may give acetaminophen (Tylenol®) or other medicines to help with symptoms.
What to expect during PBSC collection (apheresis)
Stem cell collection occurs through a procedure called apheresis.
Stem cells are collected from the blood through a process called apheresis.
During apheresis:
A needle or small tube (catheter) is placed in a vein in each arm.
Blood is drawn from a vein in one arm. An apheresis machine takes the blood and separates the stem cells from other types of blood cells. The stem cells are collected in a sterile bag.
The remainder of the blood is returned through the other arm.
Citrate is used to keep blood from clotting in the apheresis machine. Calcium is also given to help prevent reactions to citrate.
Most of the time, temporary IVs in the arms are used for this process. Occasionally, a surgically placed central line may be needed.
The apheresis process takes about 3 – 8 hours each time. The donor sits in a reclining chair or bed. Apheresis happens over 1– 3 days until enough stem cells are collected for transplant.
Apheresis side effects
Side effects of apheresis are similar to donating blood. The most common side effects are:
Some people may have side effects due to the citrate. These include:
Muscle cramps
Numbness
Feeling cold
Tingling sensations
Anxiety
Strange or metallic taste in the mouth
Seizures (in rare cases)
Important medication reminders for stem cell donors
Avoid certain medications that may increase your risk of bleeding:
Do not take aspirin, medicines that contain aspirin, or pain relievers like ibuprofen (NSAIDs) while receiving growth factor injections and for 2 weeks after your donation unless your health care provider says it’s safe.
Discuss any blood thinners or anticoagulants that you currently take with your doctor to know when these medicines may be stopped before stem cell collection.
Talk to your health care provider about blood pressure medicines such as Angiotensin-Converting Enzyme (ACE) inhibitors. They may recommend temporarily stopping this medicine to help prevent low blood pressure during the procedure. Examples of ACE inhibitors include:
Let your health care provide know about all medicines you take. Always check with your health care provider before changing any medications during this time.
When to call your care team
There is always the risk of very rare or unknown side effects. If you notice any side effects, unusual feelings, or discomfort during apheresis, tell a nurse or a doctor right away.
Please talk to your health care provider or blood donor center staff if you have questions about apheresis.
Questions to ask your care team
How does peripheral blood stem cell collection work?
What are the risks of PBSC donation?
How should I prepare for donating stem cells?
How long does stem cell collection take?
What side effects should I watch for?
When can I go back to normal activities after apheresis?
Key points about PBSC donation
Peripheral blood stem cell (PBSC) collection is a process to harvest or collect stem cells from blood in the veins (peripheral blood).
Stem cells for transplant may be collected from the patient or a donor.
Medicines called growth factors are given to help move more stem cells from the bone marrow into the bloodstream.
Stem cells are collected from the blood using a procedure called apheresis.
Most side effects of peripheral blood stem cell collection are mild and go away soon after donation.
Talk to your care team if you have questions or concerns about stem cell collection.
Apheresis may be done to collect hematopoietic (blood-forming) stem cells for transplant. Learn what to expect during apheresis for stem cell collection.
A stem cell transplant (bone marrow transplant) may be used as a treatment for some childhood cancers and blood disorders. Learn more about stem cell transplants.
