Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 25, Issue 7, Pages 1325-1330Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2019.01.034
Keywords
Unrelated donor; Bone marrow; Total nucleated cells
Categories
Funding
- Public Health Service [5U24CA076518]
- National Cancer Institute (NCI)
- National Heart, Lung and Blood Institute (NHLBI)
- National Institute of Allergy and Infectious Diseases [1U24HL138660]
- NHLBI
- NCI [HHSH250201700006C]
- Health Resources and Services Administration [N00014-17-1-2388, N00014-17-1-2850, N00014-18-1-2045]
- Office of Naval Research
- Adaptive Biotechnologies
- Match Foundation, *bluebird bio, *Bristol Myers Squibb Oncology, *Celgene
- Immucor
- Karyopharm Therapeutics, *Kite Pharma
- Medac
- Novartis Pharmaceuticals
- St. Baldrick's Foundation
- University of Minnesota
- NATIONAL CANCER INSTITUTE [ZIABC011823] Funding Source: NIH RePORTER
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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 x 10(6) cells/mL in the earliest era (1994 to 1996) to 18.7 x 10(6) 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. (C) 2019 American Society for Blood and Marrow Transplantation.
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