Prophylactic low dose continuous calcium infusion during peripheral blood stem cell (PBSC) collections to reduce citrate related toxicity

Hegde, Vikas; Setia, Rasika; Soni, Shivkumar; Handoo, Anil; Sharma, Sanjeev; Chaudhary, Dharma; Kapoor, Meenu

doi:10.1016/j.transci.2015.11.015

Cited by 21 publications

(21 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is the responsibility of collecting facility physicians' to minimize donation-related discomforts. The most common complaints associated with the lengthy procedure include activity restriction on the donation bed/chair, restriction of arm movement when peripheral access is used, and symptoms caused by citrate toxicity including numbness, tingling, muscle cramping, hypotension and arrhythmia [21,22]. A good prediction method should therefore avoid underestimation of CD34 yield for the sake of increasing the chance to obtain adequate PBSCs.…”

Section: Discussionmentioning

confidence: 99%

A Method to Predict the Yield of Peripheral Blood Stem Cells Collected by Large Volume Leukapheresis

J¹,

Burns²,

Kennedy³

et al. 2017

J Blood Lymph

View full text Add to dashboard Cite

Background: Collection of peripheral blood stem cells (PBSC) by leukapheresis has become the dominant method in allogeneic hematopoietic stem cell donation and also overpassed bone marrow donation in autologous transplantations. The circulating CD34 positive cells immediately prior to PBSC collection strongly correlate with the PBSC yield and have used to monitor donor's response to bone marrow mobilization. Methods:In this prospective study, a prediction method for PBSC collection that has been used in our facility was provided. Prediction accuracy is evaluated by comparison of predicted CD34 values to real PBSC yield. Results:The prediction method was used to determine first if a standard procedure with 12 L of blood processing could achieve the collection goal. Thirty seven donors were considered to have adequate PBSCs. Thirty four of them had a CD34 count above the target and only one donor had a CD34 count significantly below the target. For the donors whose PBSC were considered inadequate, an extended collection was performed based on the predicted blood volume that needed to be processed. The number of overestimated predictions was essentially the same as the number of underestimated predictions. Conclusion:The proposed prediction method was successful in identifying donors who needed extended collection without causing unnecessary prolongation of the leukapheresis procedure.

show abstract

Section: Discussionmentioning

confidence: 99%

A Method to Predict the Yield of Peripheral Blood Stem Cells Collected by Large Volume Leukapheresis

J¹,

Burns²,

Kennedy³

et al. 2017

J Blood Lymph

View full text Add to dashboard Cite

show abstract

“…Citrate‐related symptoms include tingling, a metallic taste, shaking, vomiting, twitching, and cramps. Prophylactic calcium supplements given during apheresis can reduce these side effects . We did not give any such supplement before apheresis, and citrate toxicity developed in five donors (3.5%) (paresthesia over the lips and extremities).…”

Section: Discussionmentioning

confidence: 99%

“…Citrate is the most commonly used anticoagulant during apheresis. Citrate reversibly chelates (and thus sequesters) blood divalent cations, including calcium (Ca) and magnesium (Mg) . Citrate‐related symptoms include tingling, a metallic taste, shaking, vomiting, twitching, and cramps .…”

Section: Introductionmentioning

confidence: 99%

“…Citrate reversibly chelates (and thus sequesters) blood divalent cations, including calcium (Ca) and magnesium (Mg) . Citrate‐related symptoms include tingling, a metallic taste, shaking, vomiting, twitching, and cramps . Citrate infusion has also been associated with reduced myocardial contractility, a fall in pulse pressure, reduced cardiac output, and even cardiac arrest.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

QTc prolongation during peripheral stem cell apheresis in healthy volunteers

Korur

Kozanoğlu

Büyükkurt

et al. 2016

J of Clinical Apheresis

View full text Add to dashboard Cite

show abstract

“…Extracorporeal anticoagulation was achieved with anticoagulant citrate dextrose-A (ACD-A), and citrate-induced hypocalcemia was prevented and/or managed with intravenous calcium gluconate supplementation. 19 Volume of blood processed for PBSC collection and volume of collection were computed by the COBE Spectra apparatus.…”

Section: Stem Cell Collectionmentioning

confidence: 99%

Reduction of peripheral blood stem cell collection sessions with extended-hour operation of the apheresis center

Wu¹,

Choo²,

Friedmann³

et al. 2018

ACP

View full text Add to dashboard Cite

Reduction of peripheral blood stem cell collection sessions with extended-hour operation of the apheresis center Submit Manuscript | http://medcraveonline.com Abbreviations: BV, blood volume; PB CD34+, peripheral blood CD34+ cell count; MM, multiple myeloma; G-CSF, granulocyte colony stimulating factor; PY, product yield; PBSC, peripheral blood stem cell IntroductionAs healthcare expenses continue to increase, and healthcare funding becomes heavily reduced, hospitals are faced with the challenge of providing quality care while curtailing costs.1 Since nursing salaries account for the highest percentage of healthcare expenditure, many hospitals have restricted the size of their nursing workforce and restructured their rosters in a manner that would adequately allocate staff to meet patient needs, while simultaneously increasing operational efficiency.1,2 At the Mount Sinai Hospital Apheresis Center, full-time apheresis nurses previously worked on an 8.5-hour shift (8:00 am-4:30 pm), five days a week. Following the recommendation of a proposed guideline for autologous PBSC collection, the previous daily maximal processing volume for each patient was increased from 3 to 4 blood volumes (BV), except when the initial peripheral blood CD34+ cell count (PB CD34+) was >120 cells/mL. 3 The time required to process the 4 BVs varies between patients, and between collection sessions, based upon flow rate, health condition of the patient, and mobilization efficiency. Four BVs was usually the maximal blood volume that could be processed within the 8.5-hour limit of daily operation of the Apheresis Center.Autologous PBSC transplantation is performed to restore hematopoietic recovery in patients with hematological malignancies, including lymphomas, multiple myeloma (MM), Amyloidosis, and certain solid tumors, 4 after high dose chemotherapy. PBSC collections are done in preparation for an autologous transplant, in which the stem cells are infused back into the patient. PBSC collection involves the collection of mobilized stem cells in the patient's blood that are used for hematopoietic reconstitution in stem cell transplantation. To maximize collection, patients undergo stem cell mobilizing regimens that consist of chemotherapy and/or granulocyte colony stimulating factor (G-CSF; filgrastim), with or without additional mobilizing agent, plerixafor, to mobilize the highest possible population of stem cells into blood circulation.4-6 the collection procedure is to process several blood volumes in an apheresis instrument, in order to reach an optimal target number of cells collected. 7 The PBSC collection product yield (PY) rises with the increase of BVs processed. The number of collection days varies among patients, depending on the peripheral blood stem cell concentration and daily BV processed. AbstractBackground: With the rising cost of healthcare, and nurses' salaries accounting for a large percentage of hospital expenses, it is crucial to maximize the efficiency of nursing services, while minimizing operational cost and impr...

show abstract

Prophylactic low dose continuous calcium infusion during peripheral blood stem cell (PBSC) collections to reduce citrate related toxicity

Cited by 21 publications

References 11 publications

A Method to Predict the Yield of Peripheral Blood Stem Cells Collected by Large Volume Leukapheresis

A Method to Predict the Yield of Peripheral Blood Stem Cells Collected by Large Volume Leukapheresis

QTc prolongation during peripheral stem cell apheresis in healthy volunteers

Reduction of peripheral blood stem cell collection sessions with extended-hour operation of the apheresis center

Contact Info

Product

Resources

About