Background/Case Studies: In ABO-incompatible bone marrow transplantation, an efficient depletion of red blood cells (RBCs) to reduce the volume before transplantation or cryopreservation is mandatory to avoid adverse events in transplanted patients. We evaluated the substitution of the RBC sedimentation using Hydroxyethyl Starch (HES) with the use of an automated cell separation device using Spectra Optia® (Terumo). Studies have demonstrated efficiency for centrifugation using automated devices with some quantitative variations between methods for volume reduction and RBC depletion and hematopoietic progenitor cells (HPC) recovery.
Study
Design/Methods: Median RBC depletion in manual method was of 80% while 97% were observed using Spectra Optia® (Terumo). Median residual RBC volume in the final product was 57mL in our previous method and 9.6mL in the automated system. CD34+ cell recovery was 75% and 75% respectively for both methods . Median platelet depletion was 22%, while volume reduction was 89% (1.465mL to 172mL) in automated system and 40% (1.615mL to 1.010mL) in manual method. The processing duration was shorter using an automated method (120 min to 180 min) when compared with the manual method (420 min to 480 min).
Results/Findings: The automated cell separation device can provide several advantages as an alternative, effective volume reduction and RBC depletion in bone marrow, while providing excellent counts of CD34+ in the final product and optimal processing time of recovery, overall procedural times using the automated method requiring an estimated 2-3 hours as opposed to the manual time requirement of around 7-8 hours. Another point to consider is that HES is not required. The volume of incompatible RBCs after processing was only 172mL, and we didn´t have any adverse reaction at the time of infusion. Conclusions: Regardless of the methods, our patients had satisfactory engraftment of neutrophils and platelets in less than 30 days post infusion.
Importance of research: We showed that we can have a drastic volume RBCs reduction of ABO incompatible bone morrow hematopoietic progenitor and time consuming process.
