Name of the Procedure:

Stem Cells (ie, CD34), Total Count

Summary

A stem cell (CD34) total count is a laboratory procedure used to measure the number of CD34-positive stem cells in a blood or bone marrow sample. These cells are vital for producing new blood cells and are commonly assessed during stem cell transplants and other medical treatments.

Purpose

The primary purpose of a stem cell CD34 total count is to evaluate the number and quality of stem cells available for transplantation. It helps in determining if there are enough stem cells for a successful stem cell or bone marrow transplant, which is critical in treating conditions such as leukemia, lymphoma, and other blood disorders.

Indications

• Diagnosed with a blood cancer (e.g., leukemia, lymphoma) requiring stem cell transplant
• Chemotherapy patients needing autologous stem cell rescue
• Bone marrow disorders
• Patients undergoing evaluation for harvest of stem cells for future use or donation

Preparation

• Patients may need to undergo a process called mobilization, which involves medications to increase the number of stem cells in the bloodstream.
• Blood tests and a physical examination are typically required prior to the procedure.
• Fasting or specific medication adjustments might be necessary, as directed by the healthcare provider.

Procedure Description

1. Blood Sample Collection: A blood sample is drawn, typically from a vein in the arm.
2. Processing: The sample is processed in a laboratory using flow cytometry, a technique to count and analyze the CD34-positive stem cells.
3. If preparing for stem cell collection: Apheresis may be performed, a process where blood is drawn, stem cells are separated, and the remaining blood is returned to the body.

Tools and Equipment:

• Needle and syringe or apheresis machine
• Flow cytometer for stem cell analysis

Anesthesia or Sedation:

• Local anesthesia may be used if apheresis is performed, but it's generally not required for just the blood draw.

Duration

• Blood draw: Approximately 15 minutes
• Apheresis: Several hours, possibly repeated over multiple days

Setting

• Hospital, outpatient clinic, or specialized apheresis unit

Personnel

• Hematologist or oncologist
• Trained lab technicians
• Nurses and potentially an apheresis specialist

Risks and Complications

• Bleeding or bruising at needle insertion site
• Infection
• In rare cases, allergic reactions to mobilizing medications
• Complications from apheresis, like low calcium levels

Benefits

• Accurate assessment of stem cell numbers and quality
• Assists in planning for successful stem cell or bone marrow transplant
• Can provide critical information for treatment decisions in blood disorders

Recovery

• Post-blood draw: Minimal recovery, slight bruising may occur
• Post-apheresis: Patients may feel tired; hydration and calcium intake are encouraged
• Specific post-procedure instructions and scheduled follow-ups will be provided by the healthcare team

Alternatives

• Bone marrow biopsy for direct stem cell count, which is more invasive
• Alternative treatments for blood disorders, such as chemotherapy without stem cell transplant

Pros and Cons of Alternatives:

• Bone marrow biopsy provides a direct count but involves a more invasive technique.
• Chemotherapy alone may be less effective in certain cases compared to transplantation.

Patient Experience

• During Blood Draw: Slight discomfort or a pinching sensation from needle insertion.
• During Apheresis: Patients usually sit or lie comfortably for several hours; often experience mild side effects like chills or tingling due to shifts in blood calcium levels.
• Post-procedure discomfort is minimal, and any related issues can be managed with the guidance of the healthcare team.