Peripheral Blood Stem Cell (PBSC) Donation  

What is PBSC donation?

Peripheral blood stem cell (PBSC) donation collects stem cells from blood in the veins (peripheral blood). Stem cells (also called progenitor cells or hematopoietic stem cells) are cells that can develop into other types of cells, such as blood cells. 

People can donate their stem cells for patients who need a stem cell transplant. 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. 

• An autologous transplant uses the patient’s own stem cells.
• An allogeneic transplant uses stem cells collected from another person (donor).

Steps of PBSC donation include:

• Tests to check the health of the donor’s blood
• Medicine to increase the number of stem cells in the blood
• Stem cell collection from blood through a vein 

Before PBSC donation

Blood tests

Before stem cell donation, the donor's blood is tested for infections, such as viruses like HIV and hepatitis. This step is important because transplant patients cannot fight infection. The stem cell transplant process weakens or wipes out the patient’s immune system to make room for the donor stem cells. 

Medicine to increase stem cells (mobilization)

The donor gets a medicine called granulocyte-colony stimulating factor (G-CSF). G-CSF helps move stem cells from the bone marrow into the blood. This process is called mobilization.

Donors get a G-CSF injection (shot) once a day for a few days. Female donors of childbearing age must have a pregnancy test before taking G-CSF.

G-CSF side effects 

Most side effects of G-CSF are mild and go away soon after the injections stop. Side effects include:

• Fatigue (feeling tired)
• Insomnia (trouble sleeping)
• Headache
• Low-grade fever
• Bone pain
• Chills

The care team may give acetaminophen (Tylenol®) or other medicines to help with symptoms.

What to expect during PBSC donation (apheresis)

Stem cells are collected from the donor’s blood through a process called apheresis. 

During apheresis:

1. A needle or small tube (catheter) is placed in a vein in each arm.  
2. 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. 
3. The remainder of the blood is returned to the donor through the other arm. 

Citrate is used to keep the blood from clotting in the apheresis machine. Calcium is also given to help prevent reactions to the 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:

• Nausea
• Dizziness
• Fainting
• Pain or bruising at the needle site

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)

Apheresis may cause a temporary drop in platelet count or white blood cell count. This is usually minor and does not cause problems for most donors.

Donors should not take aspirin, NSAIDs (like ibuprofen), or ACE inhibitors while receiving G-CSF and for 2 weeks after PBSC donation unless your health care provider says it is safe. These medicines may increase the risk of bleeding if platelet counts are low.

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 donation work?
• What are the risks of PBSC donation?
• How should I prepare for donating stem cells?
• What side effects should I watch for?
• When can I go back to normal activities?
• How does stem cell donation help patients?

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