ABO-mismatched marrow processing for transplantation: results of 114 procedures and analysis of immediate adverse events and hematopoietic recovery.
BACKGROUND
Red cell (RBC) depletion is needed to bypass ABO mismatch in allogeneic bone marrow transplantation (BMT). Technical and clinical data obtained after bone marrow (BM) processing with a continuous-flow cell separator (Cobe Spectra, Gambro BCT) are reported.


METHODS
RBC depletion and recovery of nucleated cells, CD3+ cells, CD34+ cells, and colony-forming unit-granulocyte-macrophage were calculated. Bacteriologic contaminations, side effects of graft infusion, and hematopoietic recovery were analyzed.


RESULTS
A total of 114 BM samples were processed. The mean volume collected was 1099 mL (range, 390-2450 mL). Initial and residual mean RBCs volumes were 309.9 and 4.0 mL corresponding to a depletion of 98.6 +/- 0.78 percent. Before processing, the mean numbers of nucleated cells, granulocytes, CD3+ cells, CD34+ cells, and CFU-GM were 20.28 x 10(9), 12.79 x 10(9), 1.96 x 10(9), 356.7 x 10(6), and 195.6 x 10(5), respectively. The mean corresponding recoveries after processing were 33.66, 48.98, 82.02, 82.2, and 93.9 percent. Limited side effects were observed in 14 patients without correlation with residual RBCs volume. All but two patients engrafted.


CONCLUSIONS
BM processing with the Cobe Spectra cell separator provides high rates of RBC depletion without significant side effects after BMT.
Cell Therapy Unit and Bone Marrow Transplant Department, Saint-Louis Hospital, Paris, France.
Jerome
J
Larghero
Delphine
D
Rea
Helene
H
Esperou
Nicole
N
Biscay
Marie-Noelle
MN
Maurer
Marie-Noelle
MN
Lacassagne
Brigitte
B
Ternaux
Richard
R
Traineau
Karima
K
Yakouben
Christine
C
Dosquet
Gerard
G
Socié
Eliane
E
Gluckman
Marc
M
Benbunan
Jean-Pierre
JP
Marolleau
D000017:ABO Blood-Group System; D018952:Antigens, CD34; D001781:Blood Component Removal / Q000295:instrumentation / Q000379:methods; D001788:Blood Grouping and Crossmatching; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D017252:CD3 Complex; D005260:Female; D006402:Hematologic Diseases / Q000628:therapy*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy*; D008297:Male; D014184:Transplantation, Homologous
D000017:ABO Blood-Group System; D018952:Antigens, CD34; D017252:CD3 Complex