Although peripheral blood stem cells transplants have increased over the past few decades, bone marrow (BM) cells are still the preferred source for pediatric transplants and patients with nonmalignant diseases.
BM transplant recipients are less likely to experience graft-versus-host disease. BM harvest yield is known to be an important predictor of transplant outcomes. A two year study published in TRANSFUSION evaluated donor and procedural variables for predicting BM transplant outcomes. The relationship of the weight of the donor compared to the recipient was found to significantly influence the outcome of the transplant. Only 14% of BM harvests from donors who weighed less than the transplant recipient achieved favorable total nucleated cell counts compared to 56% of harvests from heavier donors (p=0.001). Higher volume harvests were also less likely to lead to successful transplants, likely due to increased contamination of peripheral blood cells and lower total nucleated cells. Significant variation for BM harvest yield was observed between collection centers. When several well-matched donors are available, donor weight should be considered.
References
- Anthias C, Billen A, Arkwright R, Szydlo RM, Madrigal JA, Shaw BE. Harvests from bone marrow donors who weigh less than their recipients are associated with a significantly increased probability of a suboptimal harvest yield. Transfusion 2016;56: 1052-7.
- Nemecek ER. Marrow harvesting: practice makes perfect. Transfusion 2016;56: 1005.
