Prediction of nucleated cells in bone marrow stem cell products by donor characteristics: a retrospective single centre analysis

Abstract

Background and Objectives Number of total nucleated cells is an important prognostic factor of unrelated bone marrow transplantation. The objective of our study was to further optimize donor selection by finding donor characteristics which predict the total nucleated cell concentration in unrelated bone marrow products.Material and Methods Data were collected retrospectively from the pre-donation medical records. The outcome variable was concentration of total nucleated cells in the final products. We investigated several candidate predictors, including demographic variables and peripheral blood counts. A backward selection procedure was performed, using multivariable multilevel analysis.Results A total of 471 donations were included. Significant predictors were increase of age (ratio per 5 years 0AE971), cytomegalovirus (ratio 0AE947 if positive), smoking (ratio 1AE079 if yes), higher haemoglobin (ratio 1AE052 per mmol ⁄ l), higher mono-nuclear cells (ratio 1AE169 when mono-nuclear cells >2AE69 compared to mono-nuclear cells <1AE89 · 10E9 ⁄ l), increasing number of whole blood donations (ratio 1AE115 when blood donations >4 compared to blood donation <1), and larger body surface area (ratio 1AE179 when body surface area >2AE07 compared to body surface area <1AE82 m 2 ). The model was adjusted for collection volume.Conclusion Presence of all favourable factors was associated with a twofold higher concentration of total nucleated cells in the bone marrow harvest.

No Impact of Total or Myeloid Cd34+ Cell Numbers on Neutrophil Engraftment and Transplantation-Related Mortality after Allogeneic Pediatric Bone Marrow Transplantation

“…It was furthermore reported that the repopulating capacity of human BM CD34þ cells from older donors is remarkably reduced after injection into NOD/SCID/interleukin-2 receptor gamma-chain-null mice, and that a substantial decrease in the generation of myeloid cell lines was observed with rising donor age [40]. Hence, the reported correlation of total CD34þ cell numbers with NE might be explained by the fact that younger donors usually have more CD34þ cells/mL BM, albeit with a high proportion of B cell precursors [42]. Our finding that the number of infused total CD34þ cell/kg did not correlate with NE confirms previous studies [7][8][9].…”

Hematopoietic stem and progenitor cell harvesting: technical advances and clinical utility

“… 8 Other characteristics, including lower age and cytomegalovirus-negative donors, smoking, higher hemoglobin and mononuclear cell blood levels, higher number of whole blood donations in the year preceding the BM harvest, and higher body surface area, were associated with higher numbers of TNCs harvested in BM. 12 A higher hemoglobin level, higher number of whole blood donations, and smoking were probably associated with a more active hematopoiesis.…”

Bone marrow donor‐related variables associated with harvest outcome in HLA‐haploidentical transplantation with postinfusion cyclophosphamide

“…Bouwmeester et al . proposed CMV sero‐negativity, young age, smoking and high Hb values, mononuclear cell concentration in PB and BSA as positive donor‐related features, whereas only the donor's BW and WBC count resulted in statistically significant BMD predictors in the study conducted by Kao et al . .…”

“…The study population was classified first according to the BMI value (BMI ≥30: BMD mean = 25·8 TNC/ml × 10 6 ) and second by splitting the donors with a BMI value <30 into two groups based on the WBC count (WBC <8 × 10 3 /mm 3 : BMD mean = 18·4 TNC/ml × 10 6 ; WBC ≥8 × 10 3 /mm 3 : BMD mean = 23·1 TNC/ml × 10 6 ). Although BMD is not a commonly used parameter in clinical practice, it is a valid surrogate of the donor TNC content in the harvest . Several studies have shown effects of the TNC and the CD34 + cell doses on transplantation outcomes, primarily regarding the speed of haematological recovery and transplant‐related mortality, which translates into a higher overall survival .…”

“…Because the collected and infused cell dose is largely dependent on the recipient's body weight (BW) and the collected volume, the best indicator for identifying predictive donor features is BM density (BMD) in the harvest. BMD is the best indicator because the confounding variables related to the recipient's BW and the collected BM volumes have been eliminated . Few studies have been conducted to address this fact, and all of the studies analysed unrelated BM donors , who are often recruited among blood donors and thus represent a selected population; moreover, data from HLA‐haploidentical donors are lacking.…”