Donor characteristics and intra-operative total nucleated cell count
influence hematopoietic progenitor yield of healthy donor bone marrow
grafts
Abstract
Background: Bone marrow graft cell content impacts engraftment potential
after allogeneic hematopoietic cell transplantation (alloHCT).
Surrogates such as intra-operative total nucleated cell count (ioTNC),
are of unclear utility in predicting final graft characteristics. In
addition, demographic and clinical factors may influence graft cellular
profile and recipient engraftment. Procedure: We retrospectively
reviewed marrow harvests at our institution performed between 2009 and
2019. During this time, an ioTNC was measured after 50% of the
projected final graft volume was collected. Regression models were used
to assess associations between ioTNC (cells/µL) and final graft CD34+
cells/mL, and between graft and donor characteristics and final graft
CD34+ cells/mL. Results: Fifty-three marrow harvests and donor-recipient
pairs were analyzed. Median (range) donor and recipient ages were 13
(0.7-28) years and 9 (0.2-21) years, respectively. The median ratio of
donor/recipient weight was 1.225 (range 0.31-7.13). Median total volume
of harvested marrow was 15.3ml/kg (range 4.3-20.4ml/kg) of donor weight
and 19.4ml/kg (range 4.7-87.4ml/kg) of recipient weight. Median ioTNC
was 20930/µL (range 6600-44310/ µL) or 2.1x109/mL, corresponding to
median predicted final graft TNC of 3.59 x108/kg recipient weight (range
1.28-19.42x108). Simple linear regression between ioTNC and CD34+
cells/mL resulted in an R2 of 0.42. LASSO regression produced a
moderately predictive model consisting of ioTNC, donor age, and donor
weight (adjusted R2=0.7) of final graft CD34+ cells/mL. Conclusions:
ioTNC and certain donor characteristic correlate moderately well with
marrow product CD34+ cells/m, potentially informing donor selection and
marrow procurement strategies.