Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic
CPT4 code
Name of the Procedure:
Blood-derived hematopoietic progenitor cell harvesting for transplantation; allogeneic
Common Name(s): Stem cell harvest, Hematopoietic stem cell collection, Allogeneic stem cell donation
Summary
Blood-derived hematopoietic progenitor cell harvesting involves collecting stem cells from a donor's blood for transplantation to another person. These stem cells can develop into all types of blood cells and are used to treat various blood-related diseases.
Purpose
The procedure addresses conditions like leukemia, lymphoma, and other blood and bone marrow disorders. The goal is to replenish the recipient's bone marrow with healthy stem cells that can restore normal blood cell production and immune function.
Indications
- Patients with blood cancers such as leukemia or lymphoma
- Severe aplastic anemia
- Certain inherited blood disorders, like sickle cell disease
- Patients who have not responded to other treatments or need a bone marrow transplant
Donor Indications:
- Matches the human leukocyte antigen (HLA) type of the patient
- Good general health without significant underlying health issues
Preparation
- Donor will undergo a complete medical history and physical examination.
- Blood tests to ensure compatibility and overall health.
- May receive injections of growth factors (e.g., filgrastim) for several days before the procedure to increase stem cell production.
- No fasting typically required but follow any specific instructions from the doctor.
Procedure Description
- Donor receives growth factors for 4-5 days to stimulate stem cell production in the bloodstream.
- On the day of the collection, the donor is connected to an apheresis machine via a vein in the arm.
- Blood is drawn and passed through the machine, which separates and collects the hematopoietic stem cells.
- Remaining blood components are returned to the donor.
- The process is usually repeated for 1-2 days until a sufficient number of stem cells are collected.
Duration
The actual collection process can take 3-5 hours per session, typically completed over 1-2 days.
Setting
The procedure is performed in a hospital or an outpatient clinic with facilities for apheresis.
Personnel
- Hematologist or oncologist
- Apheresis nurse or technician
- Transplant coordinator
- Support staff
Risks and Complications
- Mild side effects from growth factors (e.g., bone pain, headaches)
- Risks related to the apheresis process (e.g., low calcium levels, light-headedness, bruising at the needle site)
- Rare complications include infection or allergic reactions.
Benefits
- The primary benefit is providing life-saving treatment for patients with severe blood disorders.
- Successful transplantation can lead to full restoration of normal blood and immune function.
- Immediate collection outcome but may take weeks to months for the recipient to show significant improvement.
Recovery
- Donors can usually go home the same day as the procedure.
- Mild side effects from growth factors and apheresis generally resolve in a few days.
- Follow-up to monitor health and any potential complications.
Alternatives
- Bone marrow harvesting, a more invasive procedure than peripheral blood stem cell collection.
- Umbilical cord blood transplantation.
- Each alternative has its pros and cons, such as different levels of invasiveness, recovery times, and matching criteria.
Patient Experience
- Donors may feel some discomfort from growth factor injections and the apheresis process.
- Most experience mild side effects like bone pain or fatigue.
- Pain management includes over-the-counter medications like acetaminophen.
- Overall, donors typically find the process to be tolerable and are motivated by the opportunity to help save a life.