Tissue, stem cells, and bone marrow

we are developing a new guideline for Pediatric Stem Cell collection and we have a question regarding the IV Calcium (Ca++). How can we give it? How can we calculate the dose?

For those of you who deal in HPC's - what is the slowest infusion rate that your institution uses for administration? Sources usually say that they should be infused as rapidly as possible. But our Oncology Nurse Educator would like to know what leeway nursing has to administer HPC's. Her aim is to slow the infusion rate and see if this will decrease the number of adverse reactions. Can anyone comment on that? And one more thing - what are your transplant patients normally given for meds immediately pre transplant? Our institution uses solumedrol and ativan.

We have limited liquid nitrogen storage for our autologous HPC's. Patients who have excess cells collected and are not expected to have a second transplant have those cells moved to -80C. Of course we now have a request for a second transplant on one of those patients. There is only one bag left so we can't thaw to check viability. Those cells have been at -80C for about a year and a half. Has anyone run into this type of situation and how did you handle it?

FACT requires 10 year record retention for "Facility Records", some of which are global records and policies relating to safety, maintenance, mechanical systems, and construction that are beyond our control. Our facility maintains these records per JCAHO requirements, which I believe is 3 years. How have other facilites handled this?

I'd like to know what other facilites are doing for sterility testing of HPCs (auto's only). Direct plating? Gram stain? Blood Culture - (what platform)? What is done when any result is postive? Requirements for process control include sterility. We have done blood cultures on Vitek instrument for 12 years. A new med director in micro is not allowing the use of the Vitek, as there is no literature supporting this use of the Vitek. Anyone willing to share what they do?

Are there any exceptions for the FDA ruling regarding the implementation of ISBT Code 128 for all blood products within the next couple of years? I am the Director of a low-volume progenitor cell processing facility. We support only one program and process HPCs for approximately 30 patients annually. Our facility does not provide/process any other blood products. Is there a source where I can find more detailed information regarding the FDA ruling?

Does anyone have experience with thawing, aliquoting and then re-freezing HPC's? We normally cryopreserve as soon as we get product and usually have it aliquoted before we get our yield results. In this case we had a great yield and it was stored in just two bags. The recipient got one and went into remission for almost 5 years. She is now relapsing and is up for a second transplant. There are enough cells in the remaining bag for another two transplants. So our director wants to know if there's any information on thawing, aliquoting and re-freezing product. Any data you have will be appreciated.

My hospital blood bank supports our small autologous-only peripheral blood stem cell program. My techs do both the collection (15-25 liters processed) and cryopreservation. The entire process runs into 2nd shift and involves calling in techs if a procedure has to be done on a weekend. In an attempt to reduce tech time, I would like to switch from control-rate freezing (CRF) to dump freezing. The product would be put in -80 immediately after processing and then moved to LN2 vapor storage the next day. For validation, I have multiple references comparing the two methods showing similar engraftment. I have also monitored the dump freeze cooling rate. I thawed product …

We're currently preparing for our second FACT inspection. Has anyone out there heard if there are any consultants available to help with the task?

We are in the process of taking over the skin bank. We will stock all sorts of skin products right in the Blood Bank Lab. Is anyone else out there doing the same? If so, please share your experience with it.

Would like to speak with anyone working with stem cell processing, cryopreservation and transplants. Many facilities have Hematopoietic Progenitor Cell Processing Labs as part of their Blood Bank Dept. Would like to speak with someone who performs this service on a regular basis, to share questions and ideas. Thank You! Angie