Blood and Marrow Transplantation Program, Westmead Hospital, Sydney, New South Wales, Australia.
Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, New South Wales, Australia.
Intern Med J. 2020 Mar;50(3):299-306. doi: 10.1111/imj.14419.
Donor safety is paramount when performing bone marrow stem cell harvest. The incidence of full blood count (FBC) abnormalities among donors and variables associated with anaemia after marrow harvest are not well established.
To describe the frequency of FBC abnormalities prior to bone marrow stem cell harvest and to identify variables associated with post harvest anaemia.
Outcomes of 80 consecutive adult marrow harvests performed at our centre were analysed retrospectively.
FBC abnormalities were present in 28% of donors prior to marrow harvest with normocytic anaemia the most common abnormality in 13%. Reduced donor haemoglobin (Hb) was independently correlated with lower CD34+ cell count per kg of recipient body weight. Anaemia (Hb < 100 g/L) was seen in 20% of donors after harvest with median decrease in Hb of 19 g/L. Variables independently associated with anaemia after harvest included donor to recipient weight ratio (P = 0.011), high collection volume (P = 0.044) and female gender (P = 0.023). Total nucleated cell and CD34 concentration in the final collected product were associated with the inverse of harvested marrow volume (P < 0.001).
Pre-harvest anaemia should be corrected where possible particularly in female donors. Marrow collection volume should be minimised to reduce post-harvest anaemia, optimise CD34+ cell number and improve nucleated and stem cell concentrations in the harvest product.
进行骨髓干细胞采集时，供者安全至关重要。供者全血细胞计数（FBC）异常的发生率以及骨髓采集后贫血的相关变量尚未得到充分确定。
描述骨髓干细胞采集前 FBC 异常的频率，并确定与采集后贫血相关的变量。
回顾性分析了我院 80 例连续成人骨髓采集的结果。
采集前 28%的供者存在 FBC 异常，其中以正细胞性贫血最为常见，占 13%。供者血红蛋白（Hb）降低与受体体重每公斤的 CD34+细胞计数降低独立相关。采集后 20%的供者出现贫血（Hb<100g/L），Hb 中位数下降 19g/L。与采集后贫血相关的独立变量包括供者与受体体重比（P=0.011）、采集量高（P=0.044）和女性（P=0.023）。最终采集产物中的总核细胞和 CD34 浓度与采集骨髓体积的倒数相关（P<0.001）。
应尽可能纠正采集前的贫血，尤其是女性供者。应尽量减少骨髓采集量，以降低采集后贫血、优化 CD34+细胞数量，并提高采集产物中的核细胞和干细胞浓度。
