Stem Cell Sources, Harvesting, and Clinical Use - Stem Cells and Tissue Engineering - page 33

Fig. 9.2 The last generation
of blood cell separator for
stem/progenitor cell
harvesting
respect to the required standardization of the collected SC product. During apheresis,
anticoagulation is achieved by ACD (solution A, USP). In allogeneic setting venous
access is commonly realized through peripheral (ante-cubical) veins. However,
for autologous donors—particularly for those who have received repeated
chemotherapy—SC harvest should be performed across central venous access to
circulation. Catheter-associated thrombosis is the most frequent possible complica-
tion. Also, there is around one percent hazard of the event of other complications
associated with these catheters including infection, bleeding, or pneumothorax.
Thrombocytopenia has been reported as a complication of rHuG-CSF administration
and SC collection in healthy donors [ 5, 36 ] .
Nowadays peripheral blood has largely replaced marrow as the source of SCs.
The PB-derived SC transplant is characterized by (a) less invasive cell collection
procedure; (b) absence of the risk of bone infections, general anesthesia, and work
in the surgical division; (c) faster hematopoiesis reconstruction; (d) lower cell sus-
pension volume (250-300 mL); and (e) absence or smaller level of contamination
with tumor cells than in marrow aspirate. Clinical data comparing allogeneic
peripheral blood vs. marrow transplants from HLA-identical siblings have also
shown that peripheral blood-derived SC recipients have faster engraftment,
improved hematopoietic and immune reconstitution, lower transplant-related mor-
bidity, and a similar incidence of acute GvHD. Earlier studies reported a higher
risk of chronic GvHD in allogeneic peripheral blood SC recipients. However, a
recent prospective randomized study found no difference in the incidence of this
complication [ 36- 40 ] (Fig. 9.2 ).