Primed for change: The effect of a blood prime on peripheral blood stem cell collection and accuracy of a prediction tool in pediatric patients

Abstract

Pediatric apheresis collection of peripheral blood stem cells for autologous transplantation often requires use of a blood prime. We evaluated the relationship between pre‐apheresis blood CD34+ counts and final CD34+ yield with use of a blood prime. Forty patients underwent apheresis stem cell collection in a 5 year period in our hospital, of which 27 required blood priming of the apheresis machine. Despite the blood prime group having significantly higher pre‐apheresis CD34+ cell counts, this group processed a relatively higher volume of blood due to a higher dilutional effect and collected significantly less than predicted CD34+ cell yield. Use of weight‐specific collection efficiencies and dilution‐adjusted pre‐apheresis CD34+ counts will help in accurately estimating the whole blood volume to process for PBSC collection and therefore increase efficiency and decrease the overall cost of collection.

Successful peripheral blood stem cell harvesting for two pediatric cases of atypical teratoid/rhabdoid tumor with low bodyweight

“…Blood priming is indicated in children weighing less than 25 kg to avoid hemodynamic instability. 8 In low-bodyweight children, there is also a risk of hypothermia due to the return of low-temperature blood from the circuit. Monitoring core temperature and using a blood warmer should be considered.…”