If Provenge treatment for advanced prostate cancer is a match for you, then your next step is to set up an appointment at a cell collection center. Provenge is intended for autologous use only, which means that your own blood cells are used to manufacture each dose of the drug. You will visit the cell collection center about three days prior to receiving a dose of the drug. A sample of blood will be collected from you and filtered so that only the immune cells are used to make the Provenge infusion. This procedure is called leukapheresis.
How does leukapheresis work?
Leukapheresis sounds like a complicated procedure, but it’s actually pretty simple. Blood will be drawn out of one of your arms via a catheter, filtered through a machine called a centrifuge, and the parts of the blood that will not be used will be returned to your body through a catheter in your other arm.
The centrifuge spins the blood to separate it into its basic components. These components separate because they are of different densities and weights. Once the blood is separated, your white blood cells will be removed and preserved.
How to prepare for leukapheresis
When you meet with your doctor to discuss Provenge treatment, it’s always a good idea to bring along a notebook. Write down everything that you need to prepare for the leukapheresis procedure, as well as for the actual infusion of Provenge.
Typically, you will be asked to stay well-hydrated for a few days leading up to the procedure. On the day of the leukapheresis, avoid caffeinated beverages and consume a breakfast that is rich in calcium. Some examples include yogurt with granola or oatmeal made with milk. Pair your breakfast with a glass of calcium-enriched orange juice.
Wear comfortable, loose-fitting clothing to the cell collection center. Bring the same photo ID that you used when you first enrolled for Provenge immunotherapy. It’s also a good idea to bring a book or newspaper to keep yourself occupied during the procedure. Arrange for someone to go with you, because driving yourself home afterward is not recommended.
Your doctor may give you additional instructions, or he may give you instructions regarding food and drink that differ from these. Always follow your doctor’s instructions and ask questions if anything is unclear.
What to expect during leukapheresis
Cell collection for Provenge treatment typically lasts about 3 to 4 hours. The doctor will first assess whether the veins in your arms can support intravenous catheters. If they can’t, the doctor will instead place a central venous catheter, or a central line, in your chest. Once the arm or chest catheters are in place, the blood withdrawal and filtering process will begin.
Leukapheresis is not painful, however it may be a little uncomfortable to sit in the same place for 3 to 4 hours. You will not be able to get up and move around during this time. If you need to relieve yourself, a portable urinal will be provided.
Possible side effects
If you feel any reaction at all to the procedure, alert the doctor or nurse immediately. Leukapheresis can cause a drop in calcium levels, which may result in numbness and tingling around the mouth, hands, and feet. Eating a calcium-rich breakfast can help prevent or alleviate these side effects. Other possible side effects may include chills, dizziness, nausea, and fainting. Most people also report feeling fatigued afterward.
Read more in our Prostate Cancer Health Center.