The Effect of Different Harvest Strategies on the Nucleated Cell Yields of Bone Marrow Collection

Abstract

To improve bone marrow (BM) harvest of the volunteer donors in our institute, we changed from the single-hole needle to the multi-side-hole needle after March 2002, and examined the midway total nucleated cell (TNC) counts during collection after September 2004. The aims of this retrospective study were to evaluate BM harvest yields obtained through different strategies and to examine the correlation between final and midway BM harvests. The distribution of BM harvesting by different strategies was 235 donors with single-hole needles (group A), 389 donors with 5-side-hole needles (group B), and 365 donors with 5-side-hole needles and midway TNC counts (group C). The nucleated cell density of the collected BM was significantly improved by modifying the harvest strategy (0.202 × 10(8)/mL in group A, 0.219 × 10(8)/mL in group B, and 0.250 × 10(8)/mL in group C; P < .001). The percentage of unacceptable TNC dose (<2 × 10(8)/kg) was also decreased in all 3 groups (to 5.9%, 3.6%, and 0%, respectively; P < .001). Multiple regression analysis revealed that donor weight, white blood cell count, and harvest strategy were positively correlated with BM TNC density (P < .001), whereas harvested BM volume was negatively correlated with TNC density (P < .001). On linear regression analysis, highly significant correlations were noted between midway and final TNC densities (r = 0.8774; P < .001) as well as between harvested BM volume and TNC count (r = 0.7937; P < .001). Changing the harvesting needle and checking the midway TNC count improved the harvest outcome.

Harvests from bone marrow donors who weigh less than their recipients are associated with a significantly increased probability of a suboptimal harvest yield

“…It has been consistently demonstrated that achievement of a high‐quality harvest requires lack of peripheral blood contamination, which in turn requires multiple small aspirations. Operator skill is key to achieving this, and recently concerns within the transplant community have been raised regarding problems maintaining BM harvesting expertise in the face of the declining number of BM harvests performed.…”

“…A study of 166 BM donors reported that both a higher donor body mass index (BMI) and donor weight were associated with an improved CD34 yield at BM harvest, while donor age, sex, and height had no impact on yield . Other studies have noted a correlation between high donor weight and increased quality (TNCs/mL) of BM harvested . It is also accepted that operator expertise is vital in achieving a high‐quality harvest, and variability in BM harvest quality between collection centers has been previously demonstrated …”

Impact of Donor Characteristics and HLA Matching on Survival of Chinese Patients with Hematologic Malignancies Undergoing Unrelated Hematopoietic Stem Cell Transplantation

“…The primary mission of the Tzu-Chi Stem Cell Center (also known as the Tzu-Chi Marrow Donor Registry) is to provide a suitable donor for every patient in need of transplantation, and to ensure that stem cells are collected safely and in sufficient numbers for the recipient. We sought to clarify the effects of donor characteristics on stem cell donation and unrelated transplantation in our previous and current works [14,15,[27][28][29]. Future collaborations with Chinese BM transplantation societies to further analyze long-term transplantation outcomes and the impact of recipient factors would greatly aid efforts to improve transplantation in Chinese individuals.…”

“…The planned volume of harvested bone marrow (BM) was 20 mL/kg recipient body weight, with a minimal volume of 600 mL and a maximum volume of 20 mL/kg donor weight [14]. The target CD34 1 cell dose for mobilized peripheral blood stem cells (PBSCs) was 5 Â 10 6 cells/kg recipient body weight.…”

Concise Review: Stem Cell-Based Approaches to Red Blood Cell Production for Transfusion

“…However, to maintain and expand HSPCs ex vivo in their undifferentiated state is a difficult task. Even with improved methods, we can isolate 2.5 × 10 6 to 20 × 10 6 nucleated cells from 1 ml of marrow harvested [31], of which approximately ≤1.5% are CD34 + HSPCs [32]. A 500‐ml bone marrow collection would yield 18 × 10 6 to 150 × 10 6 CD34 + HSPCs, and possibly much less in some patients who need RBC transfusion.…”