Bone marrow aspirate concentrate quality is affected by age and harvest site

Abstract

Purpose To compare the number and properties of bone marrow stromal cells (BMSCs) collected from bone marrow aspirate concentrate (BMAC) obtained from different harvest sites and from patients of different ages. Methods BMAC was obtained from two groups of patients based on age (n = 10 per group): 19.0 ± 2.7 years for the younger and 56.8 ± 12.5 for the older group. In the latter, BMAC was obtained from both iliac crest and proximal tibia for a donor-matched analysis. Mononucleated cell count and CFU-F assay were performed, together with phenotype characterization of BMSCs from iliac crest and proximal tibia, the study of chondrogenic and osteogenic differentiation capacity, histological staining and spectrophotometric quantification, and the analysis of mRNAs expression. Results Cells derived from iliac crest and proximal tibia showed the same phenotypic pattern at flow cytometry, as well as similar chondrogenic and osteogenic potential. However, a significantly higher number of mononuclear cells per ml was observed in younger patients (3.8 ± 1.8 × 107) compared to older patients (1.2 ± 0.8 × 107) (p < 0.0005). The latter yield, obtained from the iliac crest, was significantly higher than resulting from the BMAC harvested from the proximal tibia in the same group of patients (0.3 ± 0.2 × 107, p < 0.0005). This result was confirmed by the CFU-F analysis at day 10 (15.9 ± 19.4 vs 0.6 ± 1.0, p = 0.001) and day-20 (21.7 ± 23.0 vs 2.9 ± 4.2, p = 0.006). Conclusion Harvest site and age can affect the quality of BMAC. BMSCs obtained from iliac crest and proximal tibia present comparable mesenchymal markers expression as well as osteogenic and chondrogenic differentiation potential, but iliac crest BMAC presents a four times higher number of mononucleated cells with significantly higher clonogenic capacity compared to the tibia. BMAC of younger patients also had a three-time higher number of mononucleated cells. The identification of BMAC characteristics could help to optimize its preparation and to identify the most suitable indications for this orthobiologic treatment in the clinical practice.

Factors Influencing the Yield of Progenitor Cells in Bone Marrow Aspiration Concentrate—A Retrospective Analysis of 58 Patients

“…Bellantuono et al described age-related changes in the MSC pool, proliferation and differentiation capacity, and bone microarchitecture in BMAC concentrate [ 35 ]. Our results agree with the recent results by Cavallo et al [ 29 ] concerning the age and yield of BMAC.…”

“…The cellular fraction in the BMAC of males (12.70 MSCs per μL) and females (17.39 MSCs per μL) was statistically significantly different ( p < 0.001); increasing age and female sex significantly reduced the cellular fraction yield in BMAC preparation. However, Cavallo et al [ 29 ] recently clearly showed that sex does not play a role in the yield of BMAC. This is in concordance with the results of the present investigation.…”

“…Dragoo et al observed variability in the cellular mixture of BMAC prepared using various commercially available kits (Harvest SmartPrep 3, Biomet BioCUE, and Arthrex Angel) [ 5 ]. Recent studies have analyzed the role of age in the yield of BM-MSCs from BMAC [ 29 ], but the role of comorbidities and procedure variables is still unclear. The present study analyzed the influence of subjective factors such as age, sex, comorbidities, and procedure-specific variables, such as aspiration volume, on the cellular yield of progenitor cells in BMAC harvested from the iliac crest.…”

Bone Marrow Aspirate Concentrate versus Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells for Combined Cartilage Regeneration Procedure in Patients Undergoing High Tibial Osteotomy: A Systematic Review and Meta-Analysis

“…This procedure has the advantage of obtaining MSCs quickly and easily, and all processes from harvesting to transplantation can be performed in a single operation [ 41 ]. Considering the cell concentration, the most commonly used method for collecting BMAC is to collect aspirate from the iliac crest [ 42 ], but BMAC can also be collected from other sites, such as the proximal tibia [ 43 ]. Because only approximately 0.001% of MSCs of nucleated cells are obtained from aspirate, they are concentrated using density-gradient centrifugation to increase the number [ 44 ].…”

Intraoperative Creation of Tissue-Engineered Grafts with Minimally Manipulated Cells: New Concept of Bone Tissue Engineering In Situ

“…More often, bone marrow aspirate undergoes concentration to improve therapeutic cells concentration and eliminate unwanted components. Bone marrow aspirate concentrate (BMAC) contains mesenchymal stromal and stem cells, endothelial progenitor cells, hematopoietic stem cells, platelets, cytokines, and growth factors such as platelet-derived growth factor, vascular endothelial growth factor, bone morphogenetic proteins [ 107 , 108 ]. A total of 39 patients with bone defects received either collagen or hydroxyapatite scaffold enriched in BMAC in a prospective clinical trial by Jäger et al It has been shown that complete bone healing was achieved earlier in the HA group compared to collagen [ 16 ].…”