title: Routine filtration of hematopoietic stem cell products: the time has arrived.
abstract: BACKGROUND
  Most blood products are infused at the time of transfusion through a standard blood filter, designed to capture macroaggregates and cellular debris that might be harmful to the patient if infused. Hematopoietic stem cell products are not universally filtered, likely due to concern about loss of viable stem cells in the filtration process.
  
  
  METHODS
  We conducted a two-phase study to better understand the safety of routine filtration. First, surplus cryopreserved stem cell products were thawed and filtered, with markers of viability and potency measured. Second, routine filtration was implemented as part of routine practice at our center, and date of neutrophil and platelet (PLT) recovery was compared to historical controls.
  
  
  RESULTS
  In the first phase, there was no difference seen in any markers of viability or potency for products after routine filtration. Based on those results, routine filtration was implemented. There was no difference in neutrophil or PLT engraftment. Thus, in this study, routine filtration did not impact the number of viable stem cells and did not delay engraftment.
  
  
  CONCLUSIONS
  Given the very real harm posed by infusion of macroaggregates and cellular debris, and no clear disadvantage to filtration, routine filtration of stem cell products should be considered the standard of care.
authors.affiliation: Faculty of Medicine, University of Manitoba.|CancerCare Manitoba/Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada.
authors.forename: Kristjan
authors.initials: K
authors.lastname: Paulson
authors.affiliation: University of Western Ontario, London, Ontario, Canada.
authors.forename: Scott G
authors.initials: SG
authors.lastname: Gilpin
authors.affiliation: CancerCare Manitoba/Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada.
authors.forename: Tanner A
authors.initials: TA
authors.lastname: Shpiruk
authors.affiliation: CancerCare Manitoba/Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada.
authors.forename: Karla
authors.initials: K
authors.lastname: Anjos
authors.affiliation: CancerCare Manitoba/Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada.
authors.forename: Marie
authors.initials: M
authors.lastname: Tulloch
authors.affiliation: CancerCare Manitoba/Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada.
authors.forename: Angleine
authors.initials: A
authors.lastname: Giftakis
authors.affiliation: CancerCare Manitoba/Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Blankstein
authors.affiliation: Faculty of Medicine, University of Manitoba.|CancerCare Manitoba/Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Szwajcer
authors.affiliation: Faculty of Medicine, University of Manitoba.|CancerCare Manitoba/Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada.
authors.forename: Donna A
authors.initials: DA
authors.lastname: Wall
mesh_terms: D064591:Allografts; D001792:Blood Platelets / Q000166:cytology; D001793:Blood Preservation; D002449:Cell Aggregation; D002470:Cell Survival; D002498:Centrifugation; D003114:Colony-Forming Units Assay; D015925:Cryopreservation; D005374:Filtration / Q000295:instrumentation; D006085:Graft Survival; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006801:Humans; D009504:Neutrophils / Q000166:cytology; D010316:Particle Size; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D019095:Point-of-Care Systems; D012120:Respiration Disorders / Q000209:etiology; D014182:Transplantation, Autologous