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 language | English (US) |
|---|---|
| Pages (from-to) | 1325-1330 |
| Number of pages | 6 |
| Journal | Biology of Blood and Marrow Transplantation |
| Volume | 25 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2019 |
Keywords
- Bone marrow
- Total nucleated cells
- Unrelated donor
ASJC Scopus subject areas
- Hematology
- Transplantation
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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, 07.2019, p. 1325-1330.Research output: Contribution to journal › Article › peer-review
}
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.
N1 - Funding Information: Financial disclose: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases; Grant/Cooperative Agreement 1U24HL138660 from the NHLBI and NCI; Contract HHSH250201700006C with the Health Resources and Services Administration; Grants N00014-17-1-2388, N00014-17-1-2850, and N00014-18-1-2045 from the Office of Naval Research; and grants from Adaptive Biotechnologies, *Amgen, anonymous donation to the Medical College of Wisconsin, Astellas Pharma US, Atara Biotherapeutics, Be The Match Foundation, *bluebird bio, *Bristol Myers Squibb Oncology, *Celgene, *Chimerix, *CytoSen Therapeutics, Fred Hutchinson Cancer Research Center; Gamida Cell, Gilead Sciences, HistoGenetics, Immucor, *Incyte, Janssen Scientific Affairs, *Jazz Pharmaceuticals, Karius, Karyopharm Therapeutics, *Kite Pharma, Medac, *Mediware, The Medical College of Wisconsin, *Merck & Co, *Mesoblast, MesoScale Diagnostics, Millennium, *Miltenyi Biotec, Mundipharma EDO, National Marrow Donor Program; Novartis Pharmaceuticals, PCORI, *Pfizer, *Pharmacyclics, PIRCHE, *Sanofi Genzyme, *Seattle Genetics, Shire, Spectrum Pharmaceuticals, St. Baldrick's Foundation, Swedish Orphan Biovitrum, *Takeda Oncology, and the University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, the Health Resources and Services Administration, or any other agency of the US Government. *Corporate members, Conflict of interest statement: There are no conflicts of interest to report. Authorship statement: N.L.P.: study conception and design, literature search, data interpretation, manuscript writing and review; B.R.L, D.M.K. J.A.S.: study design, data collection, data analysis, figure and table generation, manuscript writing and review; P.C.: study design, data interpretation, manuscript review; I.A. P.A. A.B. C.B. J.C. S.C. D.L.C. A.D. M.A.D. N.F. H.F. S.G. D.G. U.G. G.H. P.H. R.K. K.K. H.L. J.L. H.M. M.N. P.V.O. R.O. M.P. M.A.P. B.S. N.N.S. G.E.S. J.S. E.W. B.W. and J.Y.: study design, literature review, manuscript writing and review; B.E.S.: study design, literature search, data interpretation, manuscript writing and review. Financial disclosure: See Acknowledgments on page 1330. Funding Information: Financial disclose: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases; Grant/Cooperative Agreement 1U24HL138660 from the NHLBI and NCI; Contract HHSH250201700006C with the Health Resources and Services Administration; Grants N00014-17-1-2388, N00014-17-1-2850, and N00014-18-1-2045 from the Office of Naval Research; and grants from Adaptive Biotechnologies, *Amgen, anonymous donation to the Medical College of Wisconsin, Astellas Pharma US, Atara Biotherapeutics, Be The Match Foundation, *bluebird bio, *Bristol Myers Squibb Oncology, *Celgene, *Chimerix, *CytoSen Therapeutics, Fred Hutchinson Cancer Research Center; Gamida Cell, Gilead Sciences, HistoGenetics, Immucor, *Incyte, Janssen Scientific Affairs, *Jazz Pharmaceuticals, Karius, Karyopharm Therapeutics, *Kite Pharma, Medac, *Mediware, The Medical College of Wisconsin, *Merck & Co, *Mesoblast, MesoScale Diagnostics, Millennium, *Miltenyi Biotec, Mundipharma EDO, National Marrow Donor Program; Novartis Pharmaceuticals, PCORI, *Pfizer, *Pharmacyclics, PIRCHE, *Sanofi Genzyme, *Seattle Genetics, Shire, Spectrum Pharmaceuticals, St. Baldrick's Foundation, Swedish Orphan Biovitrum, *Takeda Oncology, and the University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, the Health Resources and Services Administration, or any other agency of the US Government. Financial disclosure: See Acknowledgments on page 6. Funding Information: Financial disclose: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases ; Grant/Cooperative Agreement 1U24HL138660 from the NHLBI and NCI ; Contract HHSH250201700006C with the Health Resources and Services Administration; Grants N00014-17-1-2388 , N00014-17-1-2850 , and N00014-18-1-2045 from the Office of Naval Research; and grants from Adaptive Biotechnologies, *Amgen, anonymous donation to the Medical College of Wisconsin, Astellas Pharma US, Atara Biotherapeutics, Be The Match Foundation, *bluebird bio, *Bristol Myers Squibb Oncology, *Celgene, *Chimerix, *CytoSen Therapeutics, Fred Hutchinson Cancer Research Center; Gamida Cell, Gilead Sciences, HistoGenetics, Immucor, *Incyte, Janssen Scientific Affairs, *Jazz Pharmaceuticals, Karius, Karyopharm Therapeutics, *Kite Pharma, Medac, *Mediware, The Medical College of Wisconsin, *Merck & Co, *Mesoblast, MesoScale Diagnostics, Millennium, *Miltenyi Biotec, Mundipharma EDO, National Marrow Donor Program; Novartis Pharmaceuticals, PCORI, *Pfizer, *Pharmacyclics, PIRCHE, *Sanofi Genzyme, *Seattle Genetics, Shire, Spectrum Pharmaceuticals, St. Baldrick's Foundation, Swedish Orphan Biovitrum, *Takeda Oncology, and the University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, the Health Resources and Services Administration, or any other agency of the US Government. Publisher Copyright: © 2019 American Society for Blood and Marrow Transplantation Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/7
Y1 - 2019/7
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.
AB - 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.
KW - Bone marrow
KW - Total nucleated cells
KW - Unrelated donor
UR - http://www.scopus.com/inward/record.url?scp=85062227022&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062227022&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2019.01.034
DO - 10.1016/j.bbmt.2019.01.034
M3 - Article
C2 - 30716454
AN - SCOPUS:85062227022
VL - 25
SP - 1325
EP - 1330
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 7
ER -