Bone marrow harvest in donors with anaemia

Bartnik, Krzysztof; Pruszczyk, Katarzyna; Skwierawska, Kamila; Król, Małgorzata; Płachta, Milena; Moskowicz, Albert; Zakrzewski, T; Urbanowska, Elżbieta; Jędrzejczak, Wiesław Wiktor; Snarski, Emilian

doi:10.1111/vox.12709

Cited by 3 publications

(6 citation statements)

References 26 publications

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“…Given the low frequency of transfusion of allogeneic units, the collection of autologous units prior to BM harvest may not be justified and would result in cost and time saving for donors. This is consistent with recent reports where the need for transfusion was low . Other authors suggest that collection of autologous units is necessary prior to harvest; however, our data would dispute this proposition so long as maximum collection volumes are adhered to particularly in female donors.…”

Section: Discussionsupporting

confidence: 92%

“…This is consistent with recent reports where the need for transfusion was low. 2,9 Other authors suggest that collection of autologous units is necessary prior to harvest; 14 however, our data would dispute this proposition so long as maximum collection volumes are adhered to particularly in female donors. The first multiple regression predicted collected TNC/kg recipient weight from recipient weight, donor Hb, donor gender and volume collected.…”

Section: Discussionmentioning

confidence: 62%

“…BM harvest resulted in greater decline in haemoglobin (Hb) (mean 30 g/L) compared with PB harvest (mean 17 g/L) and this contributes to the time taken to recover fully after the procedure. The incidence of anaemia after marrow harvest has been reported as 10%, and variables associated with anaemia after harvest include collection volume and donor weight . Full blood count (FBC) parameters, particularly anaemia, can persist for up to 6 months after BM harvest.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of anaemia after marrow harvest has been reported as 10%, and variables associated with anaemia after harvest include collection volume and donor weight. 8,9 Full blood count (FBC) parameters, particularly anaemia, can persist for up to 6 months after BM harvest. Thus understanding risk factors for anaemia is relevant to improving donor safety and outcome.…”

Section: Introductionmentioning

confidence: 99%

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Pre‐ and post‐bone marrow harvest anaemia is associated with lower CD34+ stem cell collection, high harvest volume and female gender

Getta

Tong

Deren

et al. 2020

Internal Medicine Journal

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Background Donor safety is paramount when performing bone marrow stem cell harvest. The incidence of full blood count (FBC) abnormalities among donors and variables associated with anaemia after marrow harvest are not well established. Aims To describe the frequency of FBC abnormalities prior to bone marrow stem cell harvest and to identify variables associated with post harvest anaemia. Methods Outcomes of 80 consecutive adult marrow harvests performed at our centre were analysed retrospectively. Results FBC abnormalities were present in 28% of donors prior to marrow harvest with normocytic anaemia the most common abnormality in 13%. Reduced donor haemoglobin (Hb) was independently correlated with lower CD34+ cell count per kg of recipient body weight. Anaemia (Hb < 100 g/L) was seen in 20% of donors after harvest with median decrease in Hb of 19 g/L. Variables independently associated with anaemia after harvest included donor to recipient weight ratio (P = 0.011), high collection volume (P = 0.044) and female gender (P = 0.023). Total nucleated cell and CD34 concentration in the final collected product were associated with the inverse of harvested marrow volume (P < 0.001). Conclusions Pre‐harvest anaemia should be corrected where possible particularly in female donors. Marrow collection volume should be minimised to reduce post‐harvest anaemia, optimise CD34+ cell number and improve nucleated and stem cell concentrations in the harvest product.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pre‐ and post‐bone marrow harvest anaemia is associated with lower CD34+ stem cell collection, high harvest volume and female gender

Getta

Tong

Deren

et al. 2020

Internal Medicine Journal

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“…In contrast to our policy, other transplant centres (enrolling both paediatric and adult patients) have critically revised the efficacy of PAD in BM donors , and then abandoned this practice . In fact, the auto‐transfusion program in the setting of high volume BM donation undeniably constitutes a controversial issue.…”

Section: Introductionmentioning

confidence: 95%

Preoperative autologous blood donation in adult bone marrow donors: reappraisal of a single‐centre experience

et al. 2019

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To avoid risk for allogeneic transfusions in healthy bone marrow (BM) donors, 1–2 preoperative autologous blood donations (PAD) are usually collected before the BM harvest. We analysed the haematological parameters in BM donors before and after the harvest, to assess the efficacy of this practice in limiting the postharvest anaemia. Overall, 102 consecutive donors underwent BM harvest preceded by one (26 cases) or two PAD (76 cases), which were infused during BM collection. We analysed the parameters related to donors, PAD timing and BM graft characteristics. PAD induced a significant decrease in Hb (from 14·6 g/dl, IQ range 13·3–15·5 to12·9 g/dl, IQ range 11·8–13·9; P < 0·0001) in all donors, with a median Hb loss at day −1 of 10·9% (IQ range 6·8–14·2). The PAD‐related Hb decrease was independent of sex or number of PAD, and was inversely related to the time elapsed from first or last PAD. In comparison with values recorded at day‐1, BM harvest produced an additional Hb decrease, accounting for a median Hb loss of 18·9% (IQ range 14·9–24·4). Overall, in comparison with pre‐PAD values, Hb levels at day +1 were reduced of 28·9% (IQ range 23·6–32·2), independently if donors had 1 or 2 PAD reinfused. In conclusion, these data show that two PAD do not carry any advantage over one PAD. An eventual benefit of PAD can be achieved only if an adequate interval between PAD and BM harvest elapses. Prospective randomized studies could be worth to establish if any role for PAD does exist in BM donors.

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Should We Stop Collecting the Preoperative Autologous Blood before Bone Marrow Harvest?

Lysák

Hejretová

Hrabětová³

et al. 2021

JCM

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Preoperative autologous blood donation (PAD) in bone marrow (BM) donors is performed to meet potential post-harvest transfusion needs and to avoid the risk of allogeneic transfusions. We reviewed retrospectively bone marrow harvests in 216 healthy donors during a ten-year period to determine the use of autologous blood. All donors except four had undergone PAD. The initial hemoglobin level of 153 g/L (male donors) and 135 g/L (female donors), respectively, decreased by about 8 g/L after preoperative blood donation and by 23 g/L after bone marrow harvest (medians). Autologous blood was administered to 70% of donors, 30% of the units remained unused. The evaluation of the risk of reaching transfusion threshold (<115 g/L males, <105 g/L females) revealed that donors with initial hemoglobin above 145 g/L and those weighing above 75 kg have minimal risk of requiring blood substitution (about 10%). A larger volume of bone marrow was obtained from male compared to female donors (1300 vs. 1100 mL) because of their higher body weight, which resulted in a higher number of procured nucleated cells (362 vs. 307 × 106/kg TNC, ns). The donor-recipient weight difference predicted the probability of sufficient collection. Only 1.5% of donors weighing ≥ 20 kg more than recipients failed to reach ≥3 × 108/kg TNC recipient. Our findings affirm previous data that PAD is unnecessary for healthy marrow donors and may be indicated individually after considering the pre-collection hemoglobin level, donor and recipient weight, and expected blood loss. Reasonable substitution cut-offs have to be set together with clinical symptom evaluation. The effective use of PAD also requires an adequate time interval between PAD and BM harvest.

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Bone marrow harvest in donors with anaemia

Abstract: Mild anaemia prior to BMH does not significantly impact the collection results. The BMH is safe and feasible in donors with mild anaemia.

Cited by 3 publications

References 26 publications

Pre‐ and post‐bone marrow harvest anaemia is associated with lower CD34+ stem cell collection, high harvest volume and female gender

Pre‐ and post‐bone marrow harvest anaemia is associated with lower CD34+ stem cell collection, high harvest volume and female gender

Preoperative autologous blood donation in adult bone marrow donors: reappraisal of a single‐centre experience

Should We Stop Collecting the Preoperative Autologous Blood before Bone Marrow Harvest?

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