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An apheresis machine is used to collect your stem cells.
Getting to your bone marrow stem cells
Stem cells are the blood-forming cells that reside in the bone marrow. Collecting the bone marrow stem cells is the first step of the transplant process. For an autologous transplant, you will donate your own stem cells (a stem cell collection), which will be given back to you after you have completed chemotherapy.
The most common way to collect the stem cells is to use medication that causes the stem cells to leave the bone marrow and circulate in your bloodstream. This process is called stem cell mobilization. From your bloodstream, we collect your stem cells through an IV.
The medication most commonly used for stem cell mobilization is called Filgrastim, or GCSF, for Granulocyte Colony Stimulating Factor. It is given as an injection under the skin once daily. By the fifth day of fligrastim treatment, most patients will have enough stem cells in their blood stream to begin the collection procedure.
Another way to mobilize your bone marrow stem cells is to give you chemotherapy first and then GCSF injections. You may need to stay in the hospital for the chemotherapy. You can usually get the GCSF injections and stem cell collection at the UNM Cancer Center outpatient clinic. The transplant physician will determine the best mobilization regimen for you.
Stem cells are collected by connecting an IV to an apheresis machine. The apheresis machine separates your bone marrow stem cells from the other cells in your blood and then returns the remaining blood back to your body. We will place a central venous catheter into a large vein in your body. This catheter can be used for both the collection and the transplant.
Your Transplant Nurse Navigator will give you a schedule that lists your procedures and appointments.
What to expect during your collection process
A nurse connects the stem cell harvest machine to your catheter. The central venous catheter is placed into a large vein in your body before the day of your stem cell harvest.
- You will come to the UNM Cancer Center and we will draw blood samples to check whether you are ready to start collection.
- If the number of stem cells in your circulation is too low, we might give you an additional medication to help move your bone marrow stem cells into your bloodstream. One common medication for this is called Plerixafor. If there are enough stem cells in your bloodstream to begin collection, we will connect the apheresis machine to your catheter.
- The apheresis machine will circulate your blood through the machine, remove the stem cells from your blood, and store them in a transfusion bag. The rest of your blood will be returned to you. Your blood will be circulated through the machine several times in order to collect enough stem cells. We’ll use a small amount of blood thinning medication to prevent blood clots.
- The collection process takes about three to four hours. An apheresis nurse will be with you during the entire process.
- You should feel no pain during the apheresis process. You may, however, feel tingling or muscle cramps due to changes in your calcium levels. Your nurse can treat any tingling and cramps you feel with Calcium given through your IV line, so tell your nurse if you feel anything.
- In some cases the apheresis machine will also remove some of your red blood cells or platelet during the process. These counts will be checked at the end of collection.I If your red blood cells or platelets are too low, we will give you a transfusion after the apheresis process.
- Although the procedure is usually well tolerated, you should have a caregiver available to give you a ride home afterwards.
If we don’t collect enough bone marrow stem cells from you, we will need you to repeat the collection process each day, for the next one to four days.
Once the stem cells are collected, they are processed and frozen in the laboratory and stored until it is time for your transplant.
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