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KMID : 1142020230580010028
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Blood Research
2023 Volume.58 No. 1 p.28 ~ p.35
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Can the bone marrow harvest volume be reduced safely in hematopoietic stem cell transplantation with pediatric sibling donors?
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Awatif AlAnazi
Amer Nadeem
Khawar Siddiqui
Ali AlAhmari
Ibrahim Ghemlas
Abdullah AlJefri
Hawazen AlSaedi
Saadiya Khan
Mouhab Ayas
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Abstract
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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-naive 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.
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KEYWORD
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Marrow transplant, Harvest volume, Pediatric donors
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