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CTWRUBEL

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  1. For those of you collecting HPC's using the Spectra AutoPBSC program, what do you have your harvest and chase volumes set at? We collect autologous HPC's only. After years of doing collections using the MNC program with operator control we went to the Auto PBSC several months ago. As expected, we saw the counts in our collections decrease. For our last patient we set the harvest volume at 5 ml and the chase volume at 6 ml. That seemed to make an improvemnt. Other than cryopreserving, we do not manipulate the HPC's post collection and again, our collections are autologous only. Does anyone with Auto PBSC experience have suggestions on which direction we should go in, volume wise?
  2. Has anyone come across an FDA reg that states equipment used for stem cell collection cannot be used for therapeutic procedures?
  3. 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.
  4. 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?
  5. I'm getting conflicting info from two sources. Our trauma service is asking us to update our massive transfusion protocol and to consider adding in guidelines for when physicians should start adding in components like thawed plasma and platelets, i.e. when X number of red cells are issued give Y units of thawed plasma and Z number of platelets. One of our Blood Bank physicians is reluctant to do this saying the trend is to get away from specific numbers. As far as the trauma service is concerned their patients are usually not in the ED for very long so for the most part they just transfuse red cells to keep the patient alive till he/she reaches the OR. Then the surgical team takes over and deals with proper component ordering. But as far as massive transfusion goes, have I been missing the boat? What is the current thinking/practice out there?
  6. Good idea Kate. Unfortunately, we recently did a major purge of products collected from patients who are now deceased. We had added a clause to the HPC consent that allows us to discard unused product from deceased patients. We may have a few products left from collections done before the change was made to the consent. However, the program director is still waiting to hear back from next-of-kin to see if we can discard those products, so I don't think we could use those just yet. Our hematology lab does the viability studies but their results have been all over the place. I will bring it up to the director in any case and will let you know what the outcome is. Carl
  7. 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.
  8. 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?
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