Processing of autologous bone marrow cells by apheresis technology for cell-based cardiovascular regeneration.
OBJECTIVE
Bone marrow (BM)-derived mononuclear cell (MNC) preparations are increasingly used in experimental studies exploring the potential effect of progenitor cell-derived therapies in cardiocirculatory diseases. We analyzed the cellular BM composition, side-effects and other process-related variables of BM harvest and BM-MNC preparation in 80 patients with cardiovascular disease.


METHODS
BM (median 828 mL, range 223-1038 mL) was collected from the iliac crest. After BM harvest the MNC fraction was enriched by semi-automatic apheresis to reduce the total volume of the transplant. Autologous red blood cells (RBC) were salvaged from the initial BM harvest and autotransfused to the patients.


RESULTS
There were no serious side-effects related to BM collection, particularly no serious bleeding complications. Twenty- five of 80 (31%) patients developed mild pain. BM harvest resulted in the collection of a median of 2.8 × 10(9) MNC, containing a median of 66.5 × 10(6) CD34/45 cells, 39.5 × 10(6) CD133/45 cells and 50.3 × 10(6) CD34/CD133 cells. Apheresis technology-based MNC enrichment of harvested BM resulted in a progenitor cell recovery of 69-75.3% of total cells. Additional salvage of RBC from the initial BM harvest resulted in the recovery of a median of 175.0 mL autologous RBC mass. Transfusion of salvaged RBC was well tolerated and resulted in a significant increase in hemoglobin levels.


CONCLUSIONS
Collection of BM of up to 1 L in combination with in vitro processing using a semi-automated apheresis device is a safe and feasible approach to increasing the number of progenitor cells necessary for cellular therapies, particularly when combined with RBC salvage.
Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria. markus.dettke@meduniwien.ac.at
Markus
M
Dettke
Gerda
G
Leitner
Christoph W
CW
Kopp
Ying
Y
Chen
Mariann
M
Gyöngyösi
Irene
I
Lang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001781:Blood Component Removal / Q000379:methods; D001854:Bone Marrow Cells / Q000166:cytology*; D016026:Bone Marrow Transplantation; D002318:Cardiovascular Diseases / Q000628:therapy; D002452:Cell Count; D018929:Cell Culture Techniques / Q000379:methods*; D002454:Cell Differentiation; D064987:Cell- and Tissue-Based Therapy; D004912:Erythrocytes / Q000166:cytology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D044968:Regenerative Medicine