What is Peripheral Blood Hematopoietic Stem Cell Collection?

Through subcutaneous injections of granulocyte colony-stimulating factor (G-CSF), hematopoietic stem cells are stimulated to migrate from the bone marrow into peripheral blood. These stem cells are then collected using an apheresis machine, while the remaining blood is returned to the body through another vein.
Each collection session lasts approximately 4–6 hours. The total number of collection days depends on the amount of stem cells collected per session. Generally, 1–2 days are sufficient, though a small number of patients may require 3 days of collection.

Collection Procedures for Autologous Transplant Patients and Healthy Donors

• For Autologous Transplant Patients
• Begin G-CSF injections (as prescribed) twice daily (morning and evening) starting 4 days before collection. Continue until collection is completed.
• Store G-CSF in the refrigerator at 2–8°C.
• For Healthy Donors
• Complete Medical Evaluations
• Phase 1: Donors willing to match a patient will first undergo blood testing for HLA (human leukocyte antigen) typing. A physician will review the results to determine eligibility.
• Phase 2: If eligible, donors will undergo further testing, including: CBC, ABO/Rh blood type, liver function, syphilis (RPR), hepatitis B and C, HIV, and HTLV-I/II antibody screening.
• Begin G-CSF Injections
• Follow medical instructions and receive G-CSF injections twice daily for 4 days before collection, continuing until the collection is completed.
• Two Weeks Before Collection
• Avoid public places to prevent infection.
• Maintain good nutrition, sleep, and bowel habits.
• Increase calcium intake through foods such as milk, sesame, tofu, lean meat, etc.
• Stay well-hydrated.
• Possible side effects of G-CSF include bone pain, headache, fatigue, and mild fever. These can be managed with medication (e.g., fever reducers) as prescribed.
• Admission
• Hospital admission is arranged one day prior to the scheduled collection.

On the Day of Admission

• Peripheral veins will be assessed. IV cannulas will be inserted in both elbows.
• If veins are too small or not elastic enough, a double-lumen central venous catheter will be inserted in the groin area. (Please bring loose shorts if a groin catheter is needed.)
• During the collection, you will remain in bed for 4–6 hours.
• You may eat and drink normally.
• Use the restroom before the procedure; do not reduce water intake to avoid urination. Adequate hydration ensures smooth blood flow and efficient stem cell collection.

Normal daily fluid intake: approximately 2000–3000 ml

During the collection, you will remain in bed for 4–6 hours.

Possible Discomfort During Collection

• Numbness in extremities or face: Caused by a drop in blood calcium levels. Calcium gluconate will be administered 30 minutes before the procedure to relieve symptoms. Inform medical staff if symptoms persist.
• Chills or shivering: Due to blood circulating outside the body. Warm blankets or heat lamps will be used for comfort.

Post-Collection Care

• Rest in the ward while waiting for the physician to confirm sufficient stem cell count.
• Once confirmed, IV cannulas or catheters will be removed.
• Ensure the catheter site is not bleeding or uncomfortable before discharge.
• Keep the catheter site dry and clean. Avoid water contact for at least 24 hours.
• Consume foods rich in protein and calcium such as lean meat, tofu, milk, and small dried fish.
• Get plenty of rest, drink enough fluids, and maintain good sleep.
• Bone pain and fatigue usually subside naturally within 1–2 days after stopping G-CSF injections.
• A physician can issue a medical certificate if you need sick leave.
• No follow-up is needed unless complications occur. You may return to work based on your own condition.