Transfusion medicine handbook

9. Other Services Provided by NZBS

9.3 Cellular Therapy Services

There are some services available for collection of cells for therapeutic use:

• Allogeneic and autologous haematopoietic progenitor cells (stem cells): Some NZBS centres collect these for future transplants. NZBS undertakes associated activities like stem cell viability testing, cryopreservation, storage and transport. Close liaison between NZBS and the stem cell transplant teams are needed so that vein assessment, central venous line placement (if needed), timing of collection, cell collection targets, and recording of storage/disposal or return requirements for the harvest can be arranged. Local procedures should be followed.
• Granulocytes: These have been in use for about four decades to treat patients with neutropenia-associated severe infections. It can be difficult to collect the optimal dose of granulocytes required so allogeneic donors are treated with G-CSF and dexamethasone to increase circulating granulocyte number. Donors then undergo apheresis to separate granulocytes from the blood. Hydroxyethyl starch (HES) is needed to reduce the red cell contamination and improve the purity of the granulocyte product.
• Lymphocytes (CD3+): Occasionally these are requested from previous allogeneic stem cell donors when the recipient’s cancer has relapsed. These cells can also be collected pre-emptively.
• Cord blood: NZBS does not provide a routine collection and cord blood cryopreservation service. A limited service is available that is primarily aimed at families where there is a child with a pre-existing disorder that is amenable to treatment by HPC transplantation. This will provide short-term storage only. All requests for access to this service will be assessed by the Auckland City Hospital Transplant Advisory Committee and only those requests that are approved will be eligible to be accepted onto the programme.