The comparison of the effectiveness on three methods of calcium supplementation for preventing citrate intoxication during peripheral blood stem cell harvesting

Abstract

Objective To study the best method of calcium supplementation for preventing citrate intoxication(CI)during peripheral blood stem cell(PBSC)harvesting.Methods According to the different methods of administration of calcium gluconate, 166 procedures of PBSC harvesting in 141 patients/donors were randomly divided into three groups - group oral administration, group intravenous injection and group intravenous drip.In group oral administration(n = 66), 10% calcium gluconate 20 ml in 10% GS 20 ml was administrated by oral one time per hour during harvesting.When symptoms of CI appeared, extra administration was given.In group intravenous injection(n = 52), 10% calcium gluconate 10 ml in 10% GS 20 ml was administrated for intravenous injection per hour during harvesting.When symptoms of CI appeared, extra administration was given.In group intravenous drip(n =50), 10% calcium gluconate 30 ml in 10% GS 350 ml was administrated for intravenous drip at the speed of 25 - 30 drops per minute during harvesting.When symptoms of CI appeared, accelerate the intravenous drip.Symptoms of CI were observed and recorded during harvesting.Results The incidences of CI in three groups were 28.1% , 18.2% and 10.0% in which 12 were mild degree and 6 were moderate degree in group oral administration, 7 were mild degree and 1 was moderate degree in group intravenous injection and all 5 were mild degree in group intravenous drip.The mean time of starting symptoms of CI in group oral administration, group intravenous injection and group intravenous drip were 122 minutes, 134 minutes and 172 minutes.There were statistical differences of the incidence(χ2 =6.612, P ＜0.05＝ and the degrees(χ2=7.290, P ＜0.05)of CI among three groups.Both the incidence and degree of CI was the lowest and lightest in group intravenous drip among the three groups.There was no statistical difference of the mean time of starting CI among the three groups(χ2= 1.427, P ＞ 0.05).Conclusions Intravenous drip of calcium gluconate is the best and safe method for effectively preventing the CI during PBSC harvesting. Key words: Peripheral blood stem cell ; Harvesting/collection ; Citrate intoxication ; Calcium supplementation ;