The Concentration of Total Nucleated Cells in Harvested Bone Marrow for Transplantation Has Decreased over Time

Nicole L. Prokopishyn, Brent R. Logan, Deidre M. Kiefer, Jennifer A. Sees, Pintip Chitphakdithai, Ibrahim A. Ahmed, Paolo N. Anderlini, Amer M. Beitinjaneh, Christopher Bredeson, Jan Cerny, Saurabh Chhabra, Andrew Daly, Miguel Angel Diaz, N. Farhadfar, Haydar A. Frangoul, Siddhartha Ganguly, Dennis A. Gastineau, U. Gergis, Gregory A. Hale, Peiman Hematti & 19 others Rammurti T. Kamble, Kimberly A. Kasow, Hillard M. Lazarus, Jane L. Liesveld, Hemant S. Murthy, M. Norkin, Richard F. Olsson, Mona Papari, Bipin N. Savani, Jeffrey Szer, Edmund K. Waller, Baldeep Wirk, Jean A. Yared, Michael A. Pulsipher, Nirali N. Shah, Galen E. Switzer, Paul V. O'Donnell, Dennis L. Confer, Bronwen E. Shaw

Research output: Contribution to journalArticle

Abstract

Bone marrow (BM) is an essential source of hematopoietic stem cell grafts for many allogeneic hematopoietic cell transplant (HCT) recipients, including adult patients (for specific diseases and transplantation strategies) and the majority of pediatric recipient. However, since the advent of granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (PBSC) grafts, there has been a significant decrease in the use of BM in HCT, thought to be due mainly to the increased logistical challenges in harvesting BM compared with PBSCs, as well as generally no significant survival advantage of BM over PBSCs. The decreased frequency of collection has the potential to impact the quality of BM harvests. In this study, we examined >15,000 BM donations collected at National Marrow Donor Program centers between 1994 and 2016 and found a significant decline in the quality of BM products, as defined by the concentration of total nucleated cells (TNCs). The mean TNC concentration in BM donations dropped from 21.8 × 106 cells/mL in the earliest era (1994 to 1996) to 18.7 × 106 cells/mL in the most recent era (2012 to 2016) (means ratio, .83; P < .001). This decline in BM quality was seen despite the selection of more donors perceived to be optimal (eg, younger and male). Multivariate regression analysis showed that higher-volume centers (performing >30 collections per era) had better-quality harvests with higher concentrations of TNCs collected. In conclusion, we have identified a significant decrease in the quality of BM collections over time, and lower-volume collection centers had poorer-quality harvests. In this analysis, we could not elucidate the direct cause for this finding, suggesting the need for further studies to investigate the key factors responsible and to explore the impact on transplant recipients.

Original languageEnglish (US)
Pages (from-to)1325-1330
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume25
Issue number7
DOIs
StatePublished - Jul 1 2019

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Bone Marrow Transplantation
Bone Marrow
Transplants
Granulocyte Colony-Stimulating Factor
Hematopoietic Stem Cells
Transplantation
Tissue Donors
Pediatrics
Survival

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Prokopishyn, N. L., Logan, B. R., Kiefer, D. M., Sees, J. A., Chitphakdithai, P., Ahmed, I. A., ... Shaw, B. E. (2019). The Concentration of Total Nucleated Cells in Harvested Bone Marrow for Transplantation Has Decreased over Time. Biology of Blood and Marrow Transplantation, 25(7), 1325-1330. https://doi.org/10.1016/j.bbmt.2019.01.034
Prokopishyn, Nicole L. ; Logan, Brent R. ; Kiefer, Deidre M. ; Sees, Jennifer A. ; Chitphakdithai, Pintip ; Ahmed, Ibrahim A. ; Anderlini, Paolo N. ; Beitinjaneh, Amer M. ; Bredeson, Christopher ; Cerny, Jan ; Chhabra, Saurabh ; Daly, Andrew ; Diaz, Miguel Angel ; Farhadfar, N. ; Frangoul, Haydar A. ; Ganguly, Siddhartha ; Gastineau, Dennis A. ; Gergis, U. ; Hale, Gregory A. ; Hematti, Peiman ; Kamble, Rammurti T. ; Kasow, Kimberly A. ; Lazarus, Hillard M. ; Liesveld, Jane L. ; Murthy, Hemant S. ; Norkin, M. ; Olsson, Richard F. ; Papari, Mona ; Savani, Bipin N. ; Szer, Jeffrey ; Waller, Edmund K. ; Wirk, Baldeep ; Yared, Jean A. ; Pulsipher, Michael A. ; Shah, Nirali N. ; Switzer, Galen E. ; O'Donnell, Paul V. ; Confer, Dennis L. ; Shaw, Bronwen E. / The Concentration of Total Nucleated Cells in Harvested Bone Marrow for Transplantation Has Decreased over Time. In: Biology of Blood and Marrow Transplantation. 2019 ; Vol. 25, No. 7. pp. 1325-1330.
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abstract = "Bone marrow (BM) is an essential source of hematopoietic stem cell grafts for many allogeneic hematopoietic cell transplant (HCT) recipients, including adult patients (for specific diseases and transplantation strategies) and the majority of pediatric recipient. However, since the advent of granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (PBSC) grafts, there has been a significant decrease in the use of BM in HCT, thought to be due mainly to the increased logistical challenges in harvesting BM compared with PBSCs, as well as generally no significant survival advantage of BM over PBSCs. The decreased frequency of collection has the potential to impact the quality of BM harvests. In this study, we examined >15,000 BM donations collected at National Marrow Donor Program centers between 1994 and 2016 and found a significant decline in the quality of BM products, as defined by the concentration of total nucleated cells (TNCs). The mean TNC concentration in BM donations dropped from 21.8 × 106 cells/mL in the earliest era (1994 to 1996) to 18.7 × 106 cells/mL in the most recent era (2012 to 2016) (means ratio, .83; P < .001). This decline in BM quality was seen despite the selection of more donors perceived to be optimal (eg, younger and male). Multivariate regression analysis showed that higher-volume centers (performing >30 collections per era) had better-quality harvests with higher concentrations of TNCs collected. In conclusion, we have identified a significant decrease in the quality of BM collections over time, and lower-volume collection centers had poorer-quality harvests. In this analysis, we could not elucidate the direct cause for this finding, suggesting the need for further studies to investigate the key factors responsible and to explore the impact on transplant recipients.",
author = "Prokopishyn, {Nicole L.} and Logan, {Brent R.} and Kiefer, {Deidre M.} and Sees, {Jennifer A.} and Pintip Chitphakdithai and Ahmed, {Ibrahim A.} and Anderlini, {Paolo N.} and Beitinjaneh, {Amer M.} and Christopher Bredeson and Jan Cerny and Saurabh Chhabra and Andrew Daly and Diaz, {Miguel Angel} and N. Farhadfar and Frangoul, {Haydar A.} and Siddhartha Ganguly and Gastineau, {Dennis A.} and U. Gergis and Hale, {Gregory A.} and Peiman Hematti and Kamble, {Rammurti T.} and Kasow, {Kimberly A.} and Lazarus, {Hillard M.} and Liesveld, {Jane L.} and Murthy, {Hemant S.} and M. Norkin and Olsson, {Richard F.} and Mona Papari and Savani, {Bipin N.} and Jeffrey Szer and Waller, {Edmund K.} and Baldeep Wirk and Yared, {Jean A.} and Pulsipher, {Michael A.} and Shah, {Nirali N.} and Switzer, {Galen E.} and O'Donnell, {Paul V.} and Confer, {Dennis L.} and Shaw, {Bronwen E.}",
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Prokopishyn, NL, Logan, BR, Kiefer, DM, Sees, JA, Chitphakdithai, P, Ahmed, IA, Anderlini, PN, Beitinjaneh, AM, Bredeson, C, Cerny, J, Chhabra, S, Daly, A, Diaz, MA, Farhadfar, N, Frangoul, HA, Ganguly, S, Gastineau, DA, Gergis, U, Hale, GA, Hematti, P, Kamble, RT, Kasow, KA, Lazarus, HM, Liesveld, JL, Murthy, HS, Norkin, M, Olsson, RF, Papari, M, Savani, BN, Szer, J, Waller, EK, Wirk, B, Yared, JA, Pulsipher, MA, Shah, NN, Switzer, GE, O'Donnell, PV, Confer, DL & Shaw, BE 2019, 'The Concentration of Total Nucleated Cells in Harvested Bone Marrow for Transplantation Has Decreased over Time', Biology of Blood and Marrow Transplantation, vol. 25, no. 7, pp. 1325-1330. https://doi.org/10.1016/j.bbmt.2019.01.034

The Concentration of Total Nucleated Cells in Harvested Bone Marrow for Transplantation Has Decreased over Time. / Prokopishyn, Nicole L.; Logan, Brent R.; Kiefer, Deidre M.; Sees, Jennifer A.; Chitphakdithai, Pintip; Ahmed, Ibrahim A.; Anderlini, Paolo N.; Beitinjaneh, Amer M.; Bredeson, Christopher; Cerny, Jan; Chhabra, Saurabh; Daly, Andrew; Diaz, Miguel Angel; Farhadfar, N.; Frangoul, Haydar A.; Ganguly, Siddhartha; Gastineau, Dennis A.; Gergis, U.; Hale, Gregory A.; Hematti, Peiman; Kamble, Rammurti T.; Kasow, Kimberly A.; Lazarus, Hillard M.; Liesveld, Jane L.; Murthy, Hemant S.; Norkin, M.; Olsson, Richard F.; Papari, Mona; Savani, Bipin N.; Szer, Jeffrey; Waller, Edmund K.; Wirk, Baldeep; Yared, Jean A.; Pulsipher, Michael A.; Shah, Nirali N.; Switzer, Galen E.; O'Donnell, Paul V.; Confer, Dennis L.; Shaw, Bronwen E.

In: Biology of Blood and Marrow Transplantation, Vol. 25, No. 7, 01.07.2019, p. 1325-1330.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Concentration of Total Nucleated Cells in Harvested Bone Marrow for Transplantation Has Decreased over Time

AU - Prokopishyn, Nicole L.

AU - Logan, Brent R.

AU - Kiefer, Deidre M.

AU - Sees, Jennifer A.

AU - Chitphakdithai, Pintip

AU - Ahmed, Ibrahim A.

AU - Anderlini, Paolo N.

AU - Beitinjaneh, Amer M.

AU - Bredeson, Christopher

AU - Cerny, Jan

AU - Chhabra, Saurabh

AU - Daly, Andrew

AU - Diaz, Miguel Angel

AU - Farhadfar, N.

AU - Frangoul, Haydar A.

AU - Ganguly, Siddhartha

AU - Gastineau, Dennis A.

AU - Gergis, U.

AU - Hale, Gregory A.

AU - Hematti, Peiman

AU - Kamble, Rammurti T.

AU - Kasow, Kimberly A.

AU - Lazarus, Hillard M.

AU - Liesveld, Jane L.

AU - Murthy, Hemant S.

AU - Norkin, M.

AU - Olsson, Richard F.

AU - Papari, Mona

AU - Savani, Bipin N.

AU - Szer, Jeffrey

AU - Waller, Edmund K.

AU - Wirk, Baldeep

AU - Yared, Jean A.

AU - Pulsipher, Michael A.

AU - Shah, Nirali N.

AU - Switzer, Galen E.

AU - O'Donnell, Paul V.

AU - Confer, Dennis L.

AU - Shaw, Bronwen E.

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Bone marrow (BM) is an essential source of hematopoietic stem cell grafts for many allogeneic hematopoietic cell transplant (HCT) recipients, including adult patients (for specific diseases and transplantation strategies) and the majority of pediatric recipient. However, since the advent of granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (PBSC) grafts, there has been a significant decrease in the use of BM in HCT, thought to be due mainly to the increased logistical challenges in harvesting BM compared with PBSCs, as well as generally no significant survival advantage of BM over PBSCs. The decreased frequency of collection has the potential to impact the quality of BM harvests. In this study, we examined >15,000 BM donations collected at National Marrow Donor Program centers between 1994 and 2016 and found a significant decline in the quality of BM products, as defined by the concentration of total nucleated cells (TNCs). The mean TNC concentration in BM donations dropped from 21.8 × 106 cells/mL in the earliest era (1994 to 1996) to 18.7 × 106 cells/mL in the most recent era (2012 to 2016) (means ratio, .83; P < .001). This decline in BM quality was seen despite the selection of more donors perceived to be optimal (eg, younger and male). Multivariate regression analysis showed that higher-volume centers (performing >30 collections per era) had better-quality harvests with higher concentrations of TNCs collected. In conclusion, we have identified a significant decrease in the quality of BM collections over time, and lower-volume collection centers had poorer-quality harvests. In this analysis, we could not elucidate the direct cause for this finding, suggesting the need for further studies to investigate the key factors responsible and to explore the impact on transplant recipients.

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