A-freakin-pheresis

The past three mornings I have been getting apheresis down in the treatment center. Each session takes about 4 hours and is more or less painless. Each day I started my morning at about 6:30, drag my self down to the geriatric clinic (I know, right?) and get a, or should I say two, neupogen shots. I get out of the clinic at about 7:25 or so then grab a bite of breakfast before I head to the apheresis room.

A more detailed look at what apheresis is can be found at this link : http://en.wikipedia.org/wiki/Apheresis

Particular attention should be paid to the section on leukopheresis

Heres a look at the basic setup of the apheresis machine.

Before every session the nurses would draw a CBC from my hickman and enter the information into the apheresis machine. My WBCs were pretty high, 50 the first day, 41 the second, and 38 the last. The nurse said that a level of around 20 is average for this procedure. My RBCs and HCT were low but generally stable during the treatments. My platelets declined down to 111 by the third day, and the nurse said that was totally expected. In summary, don't be suprised if all your levels drop during apheresis.



On the first day of collection I collected 1.9 million. On the second day 1.8million and 1.4 million the last day. I had an above average yield and finished in three days, but on can expect to spend 4-5 days getting apheresis. Collection times running into a week to 12 days is not unheard of.



Some advice on apheresis is to load up on calcium before you go in. They treat your blood with sodium citrate to prevent it from clotting in the machine and some of the citrate ion is inadvertantly trasfused along with your treated blood. Sparing you a lecture on inorganic chemisty I'll just say that the citrate ion pulls calcium out of your blood and you may experience symptoms of hypocalcemia.


Early symptoms of hypocalcemia include: Tingling in lips and extremities.

Later signs and symptoms of hypocalcemia: Cramps, EKG disturbances, death.

I had trouble with calcium levels the first day but after injesting a few TUMS tabs the symptoms disapeared. The nurses recommended over the counter calcium supplements during apheresis: 1000mg the evening before and 1000mg in the morning before apheresis.


The stem cells (along with RBCs, platlets and some plasma) collect in a bag while the rest of your blood is returned to your body.

Heres what one days collection looks like

Another thing to remember about apheresis is the your blood is removed from your body at normal body temperature but returns to your body at room temperature. I recommend wearing a sweatsuit and a hat during apheresis to prevent getting cold, because you will. The nurses should offer a warm blanket; I dont care how hardcore you are (because I'm the most hardcore) but when they offer the blanket, take it.

So now that I'm done collecting I start the next phase of treatment: Conditioning... The chemo part. That begins tomorrow afternoon about 2:30