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. 2023 Mar 31;58(1):28-35.
doi: 10.5045/br.2023.2022167. Epub 2023 Jan 12.

Can the bone marrow harvest volume be reduced safely in hematopoietic stem cell transplantation with pediatric sibling donors?

Awatif AlAnazi  1 , Amer Nadeem  1 , Khawar Siddiqui  1 , Ali AlAhmari  1 , Ibrahim Ghemlas  1 , Abdullah AlJefri  1 , Hawazen AlSaedi  1 , Saadiya Khan  1 , Mouhab Ayas  1
Affiliations

Can the bone marrow harvest volume be reduced safely in hematopoietic stem cell transplantation with pediatric sibling donors?

Awatif AlAnazi et al. Blood Res. .

Abstract

Background: Reduced harvest volumes in pediatric donors appear to have the potential to reduce donor-associated risks while maintaining engraftment in recipients; however, the allowable harvest volume reduction remains undefined.

Methods: We retrospectively analyzed the data pairs of 553 bone marrow (BM) harvests from pediatric (age at harvest <18 yr) sibling donors and clinical outcomes of 553 pediatric (age at infusion <14 yr) transplant-naïve recipients to assess the optimal BM harvest volume needed from pediatric donors to obtain the desired CD34+ cell count (≥3.0×106 cells per kg of recipient weight), and to study its impact on the clinical outcomes of transplantation in pediatric recipients.

Results: The minimum desired CD34+ cell count of ≥3.0×106 per kg of recipient weight was achieved for 506 (95.3%) of donor-recipient pairs. The median CD34+ cell yield was 6.4×106 per kg of recipient weight (range, 1.2‒33.8×106) in donors younger than 5 years old at harvest, 4.7×106 (range, 0.3‒28.5×106) in donors aged 5‒10 years and 2.1×106 (range, 0.3‒11.3×106) in donors older than 10 years (P<0.001).

Conclusion: The infused CD34+ cell dose (×106 cells/kg of recipient weight) had no impact on GRFS; however, a CD34+ cell dose of ＞7×106 cells/kg of recipient weight did not improve hematopoietic recovery.

Keywords: Harvest volume; Marrow transplant; Pediatric donors.

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Conflict of interest statement

Authors’ Disclosures of Potential Conflicts of Interest

No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1
Fig. 1
Harvest volume mL/kg per donor weight by CD34+ cell dose (×106 cells per kg of recipient weight).
Fig. 2
Fig. 2
CD34+ cell dose (×106 cells per kg of recipient weight) by ANC engraftment.
Fig. 3
Fig. 3
Volume harvested by ANC engraftment rate compared with proposed optimal harvest volume quantification by Fury et al. [6].
See this image and copyright information in PMC

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