Abstract
BackgroundRed blood cell (RBC) depletion is a standard graft manipulation technique for ABO-incompatible bone marrow (BM) transplants. The BM processing module for Spectra Optia, “BMC”, was previously introduced. We here report the largest series to date of routine quality data after performing 50 clinical-scale RBC-depletions.MethodsFifty successive RBC-depletions from autologous (n = 5) and allogeneic (n = 45) BM transplants were performed with the Spectra Optia BMC apheresis suite. Product quality was assessed before and after processing for volume, RBC and leukocyte content; RBC-depletion and stem cell (CD34+ cells) recovery was calculated there from. Clinical engraftment data were collected from 26/45 allogeneic recipients.ResultsMedian RBC removal was 98.2% (range 90.8–99.1%), median CD34+ cell recovery was 93.6%, minimum recovery being 72%, total product volume was reduced to 7.5% (range 4.7–23.0%). Products engrafted with expected probability and kinetics. Performance indicators were stable over time.DiscussionSpectra Optia BMC is a robust and efficient technology for RBC-depletion and volume reduction of BM, providing near-complete RBC removal and excellent CD34+ cell recovery.
Highlights
Red blood cell (RBC) depletion is a standard graft manipulation technique for ABO-incompatible bone marrow (BM) transplants
Donors and ethical considerations BM was aspirated under general anesthesia from healthy registry or family donors (n = 45) as allogeneic transplants, or from patients (n = 5) with non-malignant illnesses providing an indication for allogeneic stem cell transplantation, to serve as cryopreserved autologous back-ups because of these patients’ inherently high risk of allogeneic graft rejection
The critical qualitydefining parameters for the success of RBC-depletion of BM are recovery of CD34+ “stem cells” which are contained within the mononuclear cell population and, when performed in the context of ABO-major-incompatible BM-transplantation, near-qualitative removal of RBCs to values typically observed in peripheral blood stem cell apheresis products, i.e. to values of ≤0.5 mL/kg body weight of the recipient
Summary
Red blood cell (RBC) depletion is a standard graft manipulation technique for ABO-incompatible bone marrow (BM) transplants. Given the current preference for PBSC over BM grafts, only approximately 600 ABO major/bi-directionally mismatched BM transplants are currently performed per year in Europe. We here present data suggesting that Spectra Optia BMC may fit that description. It is the most recently developed application for the Spectra Optia apheresis device [4,5,6,7,8,9,10,11,12] which was previously introduced with respect to feasibility and initial performance data [13, 14]
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