10-15 ml/kg Marrow is usually collected from the donor’s posterior and sometimes anterior iliac crests with the donor under general or spinal anesthesia. Typically, 10-15 mL/kg of marrow is aspirated, placed in heparinized media, and filtered through 0.3 and 0.2 mm screens to remove fat and bony spicules. The collected marrow may undergo further processing depending on the clinical situation, such as the removal of red cells to prevent hemolysis in ABO-incompatible transplants, the removal of donor T cells to prevent GVHD, or attempts to remove possible contaminating tumor cells in autologous transplantation. Marrow donation is safe, with only very rare complications reported. Peripheral blood stem cells are collected by leukophoresis after the donor has been treated with hematopoietic growth factors or, in the setting of autologous transplantation, sometimes after treatment with a combination of chemotherapy and growth factors. Stem cells for transplantation are generally infused through a large-bore central venous catheter. Such infusions are usually well tolerated, although occasionally patients develop fever, cough, or shortness of breath. These symptoms usually resolve with slowing of the infusion. When the stem cell product has been cryopreserved using dimethyl sulfoxide, patients more often experience short-lived nausea or vomiting due to the odor and taste of the cryoprotectant. (Ref. Harrison, 17th Edition, Vol. 1, Pg. 714-715)
Posted on: Thu, 06 Jun 2013 05:09:51 +0000
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