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PBSC Donation

Stem cells are manufactured in the bone marrow. Small numbers of these cells are released into the blood stream and are referred to as peripheral blood stem cells, or PBSC. The small number of cells released is not sufficient for a stem cell transplant. Through the use of the drug Filgrastim, which increases the number of stem cells released into the blood stream, it's possible to collect enough stem cells directly from the blood stream to facilitate a transplant.

PBSC Donation FAQs

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Q: What is the PBSC donation process?

A: Each day, before the PBSC donation, the donor receives a daily injection of Filgrastim. After receiving the Filgrastim, peripheral blood stem cells can be collected through the process of apheresis. Donating PBSC is similar to donating platelets at a blood bank. The donor's blood is removed through a sterile needle placed in a vein in one arm and passed through an apheresis machine that separates out the stem cells. The remaining blood, minus the stem cells, is returned to the donor through a sterile needle placed in the other arm.

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Q: What is Filgrastim?

A: Filgrastim has been used for more than 10 years to increase white cell production in patients who need white blood cells to fight infections. It is similar to a substance produced naturally in the human body. For several years, it has been given to healthy donors to allow them to donate PBSC for transplants to relatives. The NMDP's investigational plan for the use of Filgrastim in unrelated healthy donors, for the purpose of providing an alternative stem cell source, has been accepted by the Food and Drug Administration ( FDA) and has been defined as an "investigational study."

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Q: Why is PBSC donation considered "investigational"?

A: The NMDP is investigating whether stem cells from the peripheral blood can be used as effectively as stem cells from bone marrow for unrelated donor transplantation. Prior to marketing or investigating a new use of a drug, the FDA requires certain steps to be followed for all clinical investigations. The NMDP has submitted all required information to the FDA, including a research protocol, and a description of the administration of Filgrastim in healthy donors. The NMDP's investigational plan for the use of Filgrastim in healthy donors, for the purpose of providing an alternative stem cell source, has been accepted by the FDA and is now considered an "investigational study."

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Q: What are the risks of PBSC donation?

A: The safety and well-being of donors and recipients is the first concern of the NMDP. A study of approximately 20,000 apheresis donations concluded that the apheresis collection procedure has a very low rate of adverse effects (Transfusion, vol. 38, October 1998).

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Q: Does PBSC donation hurt?

A: You may experience bone pain, muscle pain, nausea, insomnia and fatigue while receiving Filgrastim. Bone pain and headaches have been the most frequently reported symptoms. These symptoms disappear promptly after the stem cell collection is completed. During the apheresis procedure some donors experience a tingling feeling from the anticoagulant used to keep the cells from clotting.

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Q: Where do I go to donate PBSC? How long will it take?

A: The PBSC collection site varies by Donor Center. Some centers perform the collection at the blood center; others use a local hospital.

As with marrow donation, several factors are involved, such as the quantity of cells that need to be collected. This is based on the patient's weight. Some donors will be asked for one PBSC collection, others will be asked for two. Generally, each collection procedure takes three to five hours.

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Q: How many people have donated PBSC?

A: As of April 2000, it is estimated that more than 3,000 allogeneic transplants have been done worldwide. Most were sibling transplants, but PBSC are also increasingly used for unrelated donor transplants. More than 100 NMDP donors have donated PBSC to patients who needed a second transplant. In Europe, more than 150 unrelated donors have provided PBSC for primary unrelated donor transplants.

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Q: What are the side effects of PBSC donations?

A: Symptoms can include bone pain, muscle pain, nausea, insomnia and fatigue while receiving Filgrastim. Platelet counts may also be lowered temporarily for several weeks.