Stem cell (HPC) infusion rates

[CTWRUBEL]

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.

[djford]

I assume you are talking about cryopreserved products? We have a policy of thawing and infusion completion before 20 mins have elapsed. This can be achieved if product is cryopreserved in 50-60 mL volumes. Longer thaw periods result in cell clumping and CD34 cell death.

Another approach is to thaw and reconstitute the cells in Dextran - Albumin mixture. Flow cyrtometry studies have shown viability survival of CD34 cells under these conditions. This then would allow slower reinfusion rates.