Peripheral Blood Stem Cell Harvesting In Children

What you should know

• Peripheral blood stem cell (PBSC) harvesting is a procedure that removes stem cells from your child's blood. Stem cells are created in your child's bone marrow. Bone marrow is soft, spongy tissue inside bones. Stem cells may become healthy cells that replace cells that are damaged from sickness. Stem cells removed from your child's blood may be put back into your child or someone else. Before the procedure, your child’s caregiver will test his blood. He also will give your child medicine to increase the number of stem cells in his blood.
  
  
• Your child’s blood will go through a tube into a machine that removes the stem cells. His blood is then returned to your child’s body. Your child might have PBSC harvesting if he has chemotherapy (chemo) cancer treatment, which kills or damages many blood cells. New stem cells may help your child grow healthy blood cells to replace these damaged cells. Your child also may donate stem cells to a sick family member or someone else. New stem cells may help your child or someone else make healthier blood cells. Healthy blood cells may help your child or someone else recover faster after chemo. Stem cells also may help treat diseases such as cancer and bleeding problems.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Risks

• The procedure may not harvest enough stem cells and your child may need to have the procedure again. Your child may get an infection where the central line entered his body. During the procedure, your child may have an allergy to the medicine put in the tube to prevent his blood from clotting. The medicine that helps stem cells move into your child's blood may cause him to have bone pain. Both medicines may cause your child to have a fever (high body temperature) or chills. He also may get a headache, nausea (feeling sick to his stomach), or a rash. Your child may get a blood clot, feel dizzy, or have trouble breathing. During the procedure, your child may have very bad bleeding and need a blood transfusion.
  
  
• During the procedure, too much blood may be in the harvesting tube or machine outside of your child's body. Not enough blood in his body may cause your child to have less energy, feel dizzy, faint, or have a seizure (uncontrolled shaking). During the procedure, your child may have damage to his body organs, such as his liver, spleen, or heart. He may die from some of these problems. If your child does not have this procedure, he may not have enough healthy blood cells in his body. If your child has cancer, he may be less likely to recover after chemo treatment. Without the procedure, he or someone who needs his stem cells may become more sick or die. Call your child's caregiver if you have questions or concerns about his procedure, medicine, or care.

Getting Ready

Before your child’s procedure:

• Bring your child's medicine bottles or a list of his medicines when you see his caregiver. Tell his caregiver if your child is allergic to any medicine. Tell your child's caregiver if he uses any herbs, food supplements, or over-the-counter medicine. Ask if your child should stop using certain prescribed or over-the-counter medicines, such aspirin.
  
  
• Your child's caregiver will give him a physical exam and ask about his health history. His caregiver will ask if your child has had surgery, chemo, or a blood transfusion. Tell your child's caregiver what vaccines your child has had in the past. Also tell your child's caregiver if he has any allergies or eye problems. Your caregiver may ask if your child has other health problems, such as HIV or a blood clot.
  
  
• Before harvesting, your child's caregiver will give him medicine to increase the number of stem cells in his blood. Your child may need to take this medicine for about a week before the procedure.
  
  
• Your child will need blood tests before the procedure. These blood tests may show if your child has enough stem cells in his blood to have the procedure. If your child is donating stem cells to someone else, caregivers will make sure that their blood matches. Ask your child’s caregiver for any tests your child may need. Write down the date, time, and location of each test.

The day of your child's procedure:

• Write down the correct date, time, and location of your child's procedure.
  
  
• You will be asked to sign a legal piece of paper (consent form) for your child. The consent form gives your child's caregiver permission to do the procedure. The consent form also explains the problems that may happen during the procedure and your choices. Be sure all your questions for your child's procedure have been answered before you sign this form.
  
  
• Your child may be able to play with toys and games during the procedure. Bring some of his favorite toys and books with you to help him relax during the procedure. Ask your child's caregiver if it is okay to bring movies or video games.
  
  
• Your child's caregiver may want your child to eat certain foods on the day of the procedure. This may include food and drinks that have a lot of calcium, such as milk and yogurt.

Treatment

What will happen:

• Your child will be moved to the room where the procedure will be done. The room may have games, toys, and a TV to help your child relax. You and other family members may be asked to stay with your child during the procedure. You may be able to help your child stay calm during the procedure. Your child's caregiver will put a central line into your child's body. A central line is a tube put into a large blood vessel, often near your child's neck or collarbone. The end of the tube will be attached to a special machine. During the procedure, blood will go through the tubing then into the machine.
  
  
• The machine will remove stem cells from your child's blood and collect them into a plastic bag. The machine will then send your child's blood back into his body. The procedure may last several hours to make sure enough stem cells are harvested from your child's blood. Your child's stem cells will be sent to a lab and tested to make sure they are healthy. The stem cells may be kept frozen or stored in a refrigerator until they are transplanted.

After your child's procedure:

Your child will be taken to a room where he will rest. Caregivers will watch your child closely for any problems. Your child should not get out of bed until his caregiver says it is okay. His caregiver will tell you when it is okay for your child to go home or to his hospital room.

Waiting area:

This is an area where family and friends can wait until your child is able to have visitors. Leave a phone number or other means of contact where you can be reached if you leave the area.

Contact a caregiver if

• Your child cannot make it to his procedure on time.
  
  
• Your child has pain in his bones, muscles, stomach, or head.
  
  
• Your child seems more upset or cries more than usual.
  
  
• Your child has less energy or sleeps more than usual.
  
  
• Your child has a fever (high body temperature).
  
  
• You have questions or concerns about your child’s procedure, medicine, or care.

Seek Care Immediately if

• Your child complains of a pain in his chest.
  
  
• Your child faints.
  
  
• Your child has trouble breathing.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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