Peripheral blood stem cell donation
Stem cell donors are sometimes needed for patients who require a stem cell transplant. The donated
stem cells can come from the bone marrow or from the peripheral blood. Peripheral blood is blood in the
veins. Stem cells are early, immature cells that are produced in the bone marrow. They can grow up to
be any type of blood cell – a white cell to fight infections, a red cell to carry oxygen or a platelet to help
clot the blood. A peripheral blood stem cell donor may be the patient donating his or her own cells to be
frozen for later use or a sibling donating for his or her ill sibling.
A peripheral stem cell donation may involve two parts:
•
Stem cell mobilization
•
Stem cell collection (apheresis)
See also “GREAT information…Harvesting bone marrow stem cells.”
Before donation
Each donor will be examined for the presence of any disease or condition that may affect his or her
ability to donate stem cells safely, including viruses and other infectious diseases. This step is important
because the patient receiving the stem cells will have no way to fight infection until the new stem cells
start to grow.
Mobilization
The first step in the stem cell collection process is called mobilization. Blood stem cell “mobilization”
refers to increasing the number of circulating stem cells for collection from the donor’s peripheral blood.
The donor will receive a blood growth factor called granulocyte colony stimulating factor (G-CSF),
which will be injected once a day until enough stem cells are collected from the blood. This usually
takes 4-6 days.
The side effects of G-CSF are usually mild and temporary. The most common side effects include flulike symptoms—low-grade fever, chills, bone pain, headache and trouble sleeping. The doctor may
order Tylenol® to relieve these symptoms. The side effects usually end after the stem cells are collected.
Female donors of child-bearing age must have a pregnancy test prior to taking G-CSF.
Stem cell collection (apheresis)
Stem cells are collected using an apheresis machine. This machine takes peripheral blood from one
vein in the donor’s arm and separates the stem cells from the other types of cells in the donor’s blood.
The machine separates the stem cells and returns the remaining blood contents through the needle
in the other arm. This machine is the same type used for platelet donations. Usually this process
uses temporary IVs placed in the arms. In smaller children, surgeons may need to place a temporary
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apheresis catheter, a soft tube about 1/8-inch in diameter, placed in a large vein in the chest or groin as
the arm veins may be too small. This will be removed when the entire collection is complete. During
apheresis the anticoagulant citrate is given to prevent the blood from clotting while it is out of the body.
The apheresis process requires the donor to sit quietly from three to eight hours per day until enough
stem cells are collected for transplant. This usually takes one to three days.
Side effects of apheresis
The apheresis procedure has side effects that are similar to those that can happen when people donate
whole blood. The most common side effects include nausea, fainting, dizziness and bruising at the site
where the needle was placed. The added citrate may cause side effects including muscle cramping,
numbness, a cold feeling, tingling sensations and anxious feelings. Sometimes calcium is given, either
by mouth or through the vein, to prevent or treat these reactions. For small donors (less than 60 pounds)
the apheresis machine will be “primed” with a unit of packed red blood cells decreasing the risk of
faintness or dizziness.
Other possible side effects
After apheresis, the donor’s platelet count or white blood cell count may be lower than before the
procedure. This decrease is usually small. However, taking aspirin when the platelet count is low may
increase the chance of bleeding. We recommend that donors do not take aspirin or medicines that
contain aspirin for two weeks after peripheral blood stem cell donation while getting G-CSF
without consulting a doctor.
If you have questions about stem cell donation, talk to a doctor or nurse on the stem cell transplant team.
Adapted with permission from St. Jude Children’s Research Hospital. Revised 2003
UC Davis Cancer Center 12/06
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