Adverse Events in Peripheral Progenitor Cell Collection: A 7-Year Experience

Abstract

Collection of peripheral progenitor cells (PPC) by apheresis machines is generally regarded as a safe procedure. However, data about adverse events in PPC harvesting are scarce. In a monocentric retrospective study, the data of 540 PPC collections in a period of 7 years were reviewed. Adverse events were subdivided in collection-associated technical problems and patient/donor-related side effects. Patient/donor-related side effects occurred most often (19.8%); most of them were paresthesias due to citrate toxicity. Paresthesias were treated by oral (20.4%) or intravenous (1.1%) calcium supplementation. Problems with venous access were also seen frequently, resulting in blood flow alarms (11.3%) and blockades in the return line (4.3%). A total of 6.9% of these problems were catheter associated, requiring revision of the central venous line in 2.6%. Technical problems with the blood cell separators were observed in 11.7%. Ten PPC collections were discontinued due to adverse events. The data of this retrospective, monocentric analysis show that patient/donor-associated problems were observed in every fifth PPC harvest. Most of them were paresthesias, which could be easily treated by calcium supplementation. Problems with venous access and technical problems with the cell separators occurred in every tenth PPC collection.

Use of totally implantable catheters for peripheral blood stem cell apheresis

“…In published studies, platelet reduction varies between 37 and 38%, 11,24,26 which is close to our own results (40%).…”

“…In our series, the incidence of hypocalcemia (1.26%) and hypokalemia (50%) was close to previously published data. 12,[22][23][24][25][26] As no relation to the type of vascular access was demonstrated, we principally addressed the issue of mechanical and hemodynamic complications. In children, the ratio of the extracorporeal blood volume (285 ml when using the Gambro-Spectra separator) to the total blood volume must be monitored.…”

Harvesting of CD34 antigen‐expressing cells with a new programme for the collection of mononuclear cells with use of the Amicus (Baxter) blood cell separator

“…Side effects observed in our donors and patients were paraesthesia, haematoma and blood flow and catheter‐associated problems. This was similar to a previous analysis with different blood cell separators (Moog, 2001). McLeod and coworkers reported on a nonaccess‐related adverse effect rate of 1·66% in autologous PBSC collection (McLeod et al ., 1999).…”

Mobilization of Hematopoietic Stem Cells for Use in Autologous Transplantation

“…The most common anticoagulant is citrate dextrose, which can decrease the serum level of ionized calcium, causing symptoms of hypocalcemia, outlined in Table 6. In a retrospective study of 540 collections, paresthesias from citrate toxicity was the most prevalent adverse event (20%) during collection (Moog, 2001). Untreated low serum calcium may progress to nausea, vomiting, loss of consciousness, tetany, and seizures (Rowley, 2000).…”