Erythrocyte depletion from bone marrow: performance evaluation after 50 clinical-scale depletions with Spectra Optia BMC

Abstract

BackgroundRed blood cell (RBC) depletion is a standard graft manipulation technique for ABO-incompatible bone marrow (BM) transplants. The BM processing module for Spectra Optia, “BMC”, was previously introduced. We here report the largest series to date of routine quality data after performing 50 clinical-scale RBC-depletions.MethodsFifty successive RBC-depletions from autologous (n = 5) and allogeneic (n = 45) BM transplants were performed with the Spectra Optia BMC apheresis suite. Product quality was assessed before and after processing for volume, RBC and leukocyte content; RBC-depletion and stem cell (CD34+ cells) recovery was calculated there from. Clinical engraftment data were collected from 26/45 allogeneic recipients.ResultsMedian RBC removal was 98.2% (range 90.8–99.1%), median CD34+ cell recovery was 93.6%, minimum recovery being 72%, total product volume was reduced to 7.5% (range 4.7–23.0%). Products engrafted with expected probability and kinetics. Performance indicators were stable over time.DiscussionSpectra Optia BMC is a robust and efficient technology for RBC-depletion and volume reduction of BM, providing near-complete RBC removal and excellent CD34+ cell recovery.

ABO incompatibile graft management in pediatric transplantation

“…Most common methods of RBC removal are sedimentation under gravity, after the addition of hydroxyethyl starch (HES), separation on a Ficoll gradient and processing by a blood cell separator. The blood cell separator within an automated system is progressively becoming more and more common in the most recent practice, allowing efficient RBC removal and limited cell loss [4,6,7].…”

Red blood cell depletion in small‐volume bone marrow processing using manipulation with third‐party red blood cells: A comparison of the performance of the COBE spectra and the spectra Optia systems

“…Different manual or semiautomated techniques are used for RBC depletion before ABO‐incompatible transplantation or cryopreservation; these include gravity sedimentation with hydroxyethyl starch (HES) 7–9 or dextran, 10 the addition of third‐party RBCs to buffy coat, 11,12 and Ficoll‐Hypaque used together with blood cell separators 2,13–15 . Bone marrow processing using cell separation devices has recently been developed 16–23 . COBE Spectra (COBE BCT, Lakewood, CO, USA) is a continuous flow cell separator that isolates cells through centrifugation and buffy layer formation under the manual interface management.…”

“…These apheresis devices are used to effectively remove RBCs from large bone marrow volumes with a high rate of hematopoietic cell subpopulation recovery. [18][19][20][21][22][23] However, low RBC volume is an obstacle to the processing of small-volume bone marrow collected from or for light pediatric recipients. Previous studies reported processing of low-volume bone marrow using other cell separator systems with thirdparty RBC-manipulation or ficoll density centrifugation.…”

Transfusionsmedizinische Versorgung von Patienten nach allogener Blutstammzelltransplantation

“…Seit den 1990er-Jahren besitzt die allogene Blutstammzelltransplantation einen international anerkannten Stellenwert in der Therapie einer Vielzahl von hämatologischen und lymphatischen Neoplasien, aber auch bei angeborenen und erworbenen nichtmalignen Erkrankungen der Blutbildung und des Immunsystems. [6,7]. Die in einigen Zentren praktizierte gezielte Fehltransfusion major-inkompatibler Erythrozytenkonzentrate zur Adsorption der gegen die Spenderblutgruppe gerichteten Isoagglutinine des Empfängers ist ebenfalls effektiv, sofern der Isoagglutinintiter des Empfängers einen Wert von 32 nicht überschreitet [8,9].…”