Pre- and post-bone marrow harvest anaemia is associated with lower CD34+ stem cell collection, high harvest volume and female gender.
allogeneic stem cell
anaemia
bone marrow
donor
transplantation
Journal
Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
08
12
2018
revised:
21
05
2019
accepted:
01
07
2019
pubmed:
6
7
2019
medline:
28
4
2021
entrez:
6
7
2019
Statut:
ppublish
Résumé
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. To describe the frequency of FBC abnormalities prior to bone marrow stem cell harvest and to identify variables associated with post harvest anaemia. Outcomes of 80 consecutive adult marrow harvests performed at our centre were analysed retrospectively. 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). 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.
Sections du résumé
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.
Substances chimiques
Antigens, CD34
0
Granulocyte Colony-Stimulating Factor
143011-72-7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
299-306Informations de copyright
© 2019 Royal Australasian College of Physicians.
Références
Thomas ED, Storb R. Technique for human marrow grafting. Blood 1970; 36: 507-15.
Pruszczyk K, Skwierawska K, Krol M, Moskowicz A, Jablonski D, Torosian T et al. Bone marrow harvest from unrelated donors-up-to-date methodology. Eur J Haematol 2017; 99: 357-65.
Pulsipher MA, Chitphakdithai P, Logan BR, Shaw BE, Wingard JR, Lazarus HM et al. Acute toxicities of unrelated bone marrow versus peripheral blood stem cell donation: results of a prospective trial from the National Marrow Donor Program. Blood 2013; 121: 197-206.
Bensinger WI, Martin PJ, Storer B, Clift R, Forman SJ, Negrin R et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers. N Engl J Med 2001; 344: 175-81.
Anasetti C, Logan BR, Lee SJ, Waller EK, Weisdorf DJ, Wingard JR et al. Peripheral-blood stem cells versus bone marrow from unrelated donors. N Engl J Med 2012; 367: 1487-96.
Heldal D, Brinch L, Tjonnfjord G, Solheim BG, Egeland T, Gadeholt G et al. Donation of stem cells from blood or bone marrow: results of a randomised study of safety and complaints. Bone Marrow Transplant 2002; 29: 479-86.
Burns LJ, Logan BR, Chitphakdithai P, Miller JP, Drexler R, Spellman S et al. Recovery of unrelated donors of peripheral blood stem cells versus recovery of unrelated donors of bone marrow: a prespecified analysis from the phase III blood and marrow transplant clinical trials network protocol 0201. Biol Blood Marrow Transplant 2016; 22: 1108-16.
Favre G, Beksac M, Bacigalupo A, Ruutu T, Nagler A, Gluckman E et al. Differences between graft product and donor side effects following bone marrow or stem cell donation. Bone Marrow Transplant 2003; 32: 873-80.
Bartnik K, Pruszczyk K, Skwierawska K, Krol M, Plachta M, Moskowicz A et al. Bone marrow harvest in donors with anaemia. Vox Sang 2018; 113: 795-802.
Sartor M, Antonenas V, Garvin F, Webb M, Bradstock KF. Recovery of viable CD34+ cells from cryopreserved haemopoietic progenitor cell products. Bone Marrow Transplant 2005; 36: 199-204.
Keeney M, Chin-Yee I, Weir K, Popma J, Nayar R, Sutherland DR. Single platform flow cytometric absolute CD34+ cell counts based on the ISHAGE guidelines. International Society of Hematotherapy and Graft Engineering. Cytometry 1998; 34: 61-70.
Baertsch MA, Kriegsmann K, Pavel P, Bruckner T, Hundemer M, Kriegsmann M et al. Platelet count before peripheral blood stem cell mobilization is associated with the need for Plerixafor but not with the collection result. Transfus Med Hemother 2018; 45: 24-31.
Papanikolaou X, Rosenbaum ER, Tyler LN, Sawyer J, Heuck CJ, Barlogie B et al. Haemopoietic progenitor cell collection after autologous transplant for multiple myeloma: low platelet count predicts for poor collection and sole use of resulting graft enhances risk of myelodysplasia. Leukemia 2014; 28: 888-93.
Bosi A, Bartolozzi B. Safety of bone marrow stem cell donation: a review. Transplant Proc 2010; 42: 2192-4.
Sierra J, Storer B, Hansen JA, Bjerke JW, Martin PJ, Petersdorf EW et al. Transplantation of marrow cells from unrelated donors for treatment of high-risk acute leukemia: the effect of leukemic burden, donor HLA-matching, and marrow cell dose. Blood 1997; 89: 4226-35.
Kao RH, Li CC, Shaw CK, Wang TF, Chu SC, Chen SH et al. Correlation between characteristics of unrelated bone marrow donor and cell density of total nucleated cell in bone marrow harvest. Int J Hematol 2009; 89: 227-30.
Bacigalupo A, Tong J, Podesta M, Piaggio G, Figari O, Colombo P et al. Bone marrow harvest for marrow transplantation: effect of multiple small (2 mL) or large (20 mL) aspirates. Bone Marrow Transplant 1992; 9: 467-70.
Anthias C, Billen A, Arkwright R, Szydlo RM, Madrigal JA, Shaw BE. Harvests from bone marrow donors who weigh less than their recipients are associated with a significantly increased probability of a suboptimal harvest yield. Transfusion 2016; 56: 1052-7.
Wang TF, Chu SC, Chen SH, Huang KP, Su YC, Li DK et al. The effect of different harvest strategies on the nucleated cell yields of bone marrow collection. Biol Blood Marrow Transplant 2011; 17: 351-5.
Bouwmeester W, Fechter MM, Heymans MW, Twisk JW, Ebeling LJ, Brand A. Prediction of nucleated cells in bone marrow stem cell products by donor characteristics: a retrospective single centre analysis. Vox Sang 2010; 98: e276-83.
Frangoul H, Nemecek ER, Billheimer D, Pulsipher MA, Khan S, Woolfrey A et al. A prospective study of G-CSF-primed bone marrow as a stem-cell source for allogeneic bone marrow transplantation in children: a pediatric blood and marrow transplant consortium (PBMTC) study. Blood 2007; 110: 4584-7.