CPT® Code 38207

1. Indications

Transplant preparation of hematopoietic progenitor cells is indicated for various medical conditions that require stem cell transplantation. The following are the explicitly provided indications for this procedure:

• Hematologic Malignancies Conditions such as leukemia, lymphoma, and multiple myeloma, where high-dose chemotherapy or radiation therapy is used, necessitating the replacement of damaged bone marrow.
• Bone Marrow Failure Syndromes Disorders like aplastic anemia or myelodysplastic syndromes, which impair the bone marrow's ability to produce blood cells, may require transplantation of healthy progenitor cells.
• Inherited Blood Disorders Genetic conditions such as sickle cell disease or thalassemia, where healthy hematopoietic progenitor cells can provide a cure or significant improvement in quality of life.

2. Procedure

The procedure for transplant preparation of hematopoietic progenitor cells involves several critical steps to ensure the successful collection and preservation of the cells. Each step is essential for maintaining the integrity and viability of the progenitor cells for future transplantation.

• Step 1: Harvesting The first step involves the collection of hematopoietic progenitor cells from the donor. This can be achieved through apheresis, where blood is drawn from the donor, and the progenitor cells are separated and collected, or through bone marrow aspiration, where marrow is extracted directly from the donor's bones.
• Step 2: Cryoprotectant Treatment After harvesting, the collected cells are treated with a cryoprotectant solution. This solution is crucial as it protects the cells from ice crystal formation during the freezing process, which can cause cellular damage. The treatment is carefully administered to ensure optimal cell preservation.
• Step 3: Cryopreservation The treated cells are then subjected to a controlled freezing process, where they are gradually cooled to low temperatures. This step is vital for maintaining cell viability over extended periods. The cells are typically stored in liquid nitrogen or at -80 degrees Celsius to ensure their long-term preservation.
• Step 4: Storage Finally, the cryopreserved hematopoietic progenitor cells are stored in specialized containers designed for low-temperature storage. These containers are monitored to ensure that the temperature remains stable, safeguarding the cells until they are needed for transplantation.

3. Post-Procedure

Post-procedure care for the donor involves monitoring for any potential complications related to the harvesting process, such as pain or infection at the collection site. The donor may also require follow-up appointments to assess their recovery and overall health. For the stored hematopoietic progenitor cells, there are no immediate post-procedure care requirements, as they are preserved for future use. However, it is essential to maintain proper storage conditions and regularly check the integrity of the storage system to ensure the cells remain viable until transplantation is performed.