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Peripheral blood stem cell collection: Are midline catheters a viable alternative to central venous catheters?
Minh-Ha Tran1, Eduardo Tajonera2
1Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, California, USA.
Insights
Midline catheters offer a viable alternative for peripheral blood stem cell collection, especially for allogeneic donors. This approach may reduce risks associated with central venous catheters, though some cases may require multiple collection days.
Area of Science:
- Hematology
- Transplant Medicine
- Vascular Access
Background:
- Peripheral blood stem cell collection is crucial for various medical treatments.
- Central venous catheters (CVCs) are commonly used for vascular access but pose risks.
- Midline catheters present a potential alternative for stem cell collection.
Purpose of the Study:
- To evaluate the feasibility and outcomes of using midline catheters for peripheral blood stem cell collection.
- To review existing literature on midline catheter use in this context.
Main Methods:
- A literature search was conducted to identify studies on midline catheter use for stem cell collection.
- Data extracted included donor characteristics, collection parameters, and yield.
Main Results:
- The review included 19 patients and 26 collection events.
- Median collection yield was 5.9 × 10^6 CD34+ cells/kg.
- Seventy-four percent of donors achieved target CD34 yields, with 37% requiring two collection days.
Conclusions:
- Peripheral blood stem cell collection using midline catheters appears feasible.
- This method may be particularly suitable for allogeneic donors and shorter collection durations.
- Development of institutional guidelines for midline catheter use is recommended.
Background:
Vascular access is a rate-limiting step for peripheral blood stem cell collection. In the absence of readily accessible superficial veins, placement of tunnelled or non-tunnelled central venous catheters (CVCs) is common. These invasive access routes create medical risks for patients and are associated with logistical challenges, thus prompting a search for alternatives. One such option is the off-label use of midline catheters.
Study Design And Methods:
We carried out a literature search for published experience with the use of midline catheters for peripheral blood stem cell collection. Data extracted included whether collections were allogeneic or autologous, donor sex, age and weight, inlet flow rate, total blood volumes (TBV) processed, collection duration, number of collections per donor, and achievement of collection targets.
Results:
The search produced three reports (one in abstract form) comprising 19 patients and 26 collection events. Donor sex and status were provided for 18 patients; 10 were female, 8 were male, 12 were allogeneic, and 6 autologous. Median (range) for: donor age was 28 (12-59); donor body weight (kg) was 77.5 (45.4-113.4); inlet flow rate (in mL/min) was 66 (28-80); TBV processed (in mL) was 15,880 (6178-21,871); collection duration (in hours) was 5.0 (3.2-7.0); and CD34 × 106/kg collection yield was 5.9 (3.6-23.0). Target CD34 yields were achieved in 14/19 (74%) of donors with 7/19 (37%) requiring two collections days.
Discussion:
Peripheral blood stem cell collection does appear to be viable via midline-based catheter access, particularly for allogeneic donors and shorter collection courses. Development of institution-specific guidelines and care pathways are recommended.
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