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The Impact of Donor Baseline Characteristics on Total Nucleated Cell Count in Marrow Products of Healthy Bone Marrow Donors
Abstracts / Biol Blood Marrow Transplant 25 (2019) S100 S289
Skin contaminants were most prominent, including Coagulasenegative Staphylococcus, Propionibacterium acne, Staphylococcus saccharolyticus and Staphylococcus caprae. Since implementing the use of the antimicrobial surgical drape between 9/13/16 and 8/6/18 (n=82) there has been only one incident of contamination (1%). Conclusion: Use of an antimicrobial surgical drape during bone marrow harvest reduces the risk of graft contamination from skin flora.
281 The Impact of Donor Baseline Characteristics on Total Nucleated Cell Count in Marrow Products of Healthy Bone Marrow Donors Brennan M. Parmelee MSN, RN, CNE1,2, Josie Sena RN, OCN3, Kimberly East RN, BMTCN3, Marsha Cohen RN, OCN3, Audrey Scholoff MSN, NP4, Gloria Obi Anyadike PhD5, Jaya Paranilam PhD3, LaQuisa Hill MD6, Carlos A. Ramos MD6, Helen E. Heslop MD7, George Carrum MD8, Premal Lulla MD8. 1 Department of Cell & Gene Therapy, Houston Methodist Hospital, Houston, TX; 2 Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX; 3 Houston Methodist Hospital, Houston, TX; 4 Cell & Gene Therapy, Baylor College of Medicine, Houston, TX; 5 Center for Cell and Gene Therapy, Baylor college of Medicine, Houston Methodist Hospital, Houston, TX, Houston, TX; 6 Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston Methodist Hospital, Houston, TX; 7 Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston, TX; 8 Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital and Texas Children’s Hospital, Houston, TX Introduction: An adequate dose of marrow derived total nucleated cells (TNCs) is essential for engraftment in recipients undergoing allogeneic hematopoietic stem cell (HSC) transplant. Marrow collection centers anticipate the harvest volume required to meet a minimum collection goal of 2 £ 108 TNCs/ kg based on published aggregates of donor marrow TNC concentrations (currently set at 18.3 £ 109/L). However, marrow TNCs are highly variable among marrow donors. We hypothesized that baseline donor characteristics such as age, BMI, and ethnicity, could be used to more accurately predict TNCs. Objectives: We commissioned an IRB-approved retrospective single center study to ascertain which donor characteristics could independently predict marrow TNCs during a harvest as well as the impact on successful recipient engraftment.
S201
Methods: Univariate linear regression was conducted to estimate the crude association between each factor and TNC (487 donors). The following variables were considered as possible predictors: donor BMI, age, ethnicity, gender, and total harvest volume. Variables that had a p value <0.20 in the univariate analysis were entered into a multivariate linear regression model, in which p<0.05 was considered to be statistically significant. Results: Univariate analysis revealed no difference in TNCs between genders (p = 0.697). BMI was significantly positively correlated with TNCs (t = 4.17; p<0.0001). Age was significantly negatively correlated with TNCs (t = -2.76; p = 0.006), as was harvest volume (t = -7.97; p<0.0001). Significant differences (p<0.0001) in TNC counts were also found between ethnicities (Caucasian, Hispanic, Black, Asian, and Native American/ Mixed/Other). Asians (n=39) and AAs (n=71) had lower TNCs (mean 16.217 and 15.8, respectively) than other ethnicities. The multivariate model included BMI, volume, ethnicity, and age, all of which maintained significance in predicting TNC (Table 1). We obtained engraftment (neutrophil recovery) data for 327 recipients. Of donors for non-engrafted recipients (n=11), four were Caucasian, three Hispanic, two Asian, and one Native American/Mixed/Other. We could not demonstrate a significant difference in engraftment by ethnicity, age, nor BMI. Descriptive statistics of the TNC count differences are shown in Table 2. Conclusion: Our findings demonstrate that multiple donor characteristics can predict marrow TNCs. The impact of ethnicity on marrow TNC counts, but not on engraftment rates, suggests that the true HSC concentrations might be higher in these donors despite the lower TNCs. As donor pools diversify and use of haploidentical donors increases, our observations indicate that expected TNC counts during marrow harvests will vary based on baseline donor characteristics.
Table 1 Results from the multivariate model of significant predictors of TNC count
Table 2 Mean TNC differences among donor characteristics
Skin contaminants were most prominent, including Coagulasenegative Staphylococcus, Propionibacterium acne, Staphylococcus saccharolyticus and Staphylococcus caprae. Since implementing the use of the antimicrobial surgical drape between 9/13/16 and 8/6/18 (n=82) there has been only one incident of contamination (1%). Conclusion: Use of an antimicrobial surgical drape during bone marrow harvest reduces the risk of graft contamination from skin flora.
281 The Impact of Donor Baseline Characteristics on Total Nucleated Cell Count in Marrow Products of Healthy Bone Marrow Donors Brennan M. Parmelee MSN, RN, CNE1,2, Josie Sena RN, OCN3, Kimberly East RN, BMTCN3, Marsha Cohen RN, OCN3, Audrey Scholoff MSN, NP4, Gloria Obi Anyadike PhD5, Jaya Paranilam PhD3, LaQuisa Hill MD6, Carlos A. Ramos MD6, Helen E. Heslop MD7, George Carrum MD8, Premal Lulla MD8. 1 Department of Cell & Gene Therapy, Houston Methodist Hospital, Houston, TX; 2 Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX; 3 Houston Methodist Hospital, Houston, TX; 4 Cell & Gene Therapy, Baylor College of Medicine, Houston, TX; 5 Center for Cell and Gene Therapy, Baylor college of Medicine, Houston Methodist Hospital, Houston, TX, Houston, TX; 6 Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston Methodist Hospital, Houston, TX; 7 Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston, TX; 8 Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital and Texas Children’s Hospital, Houston, TX Introduction: An adequate dose of marrow derived total nucleated cells (TNCs) is essential for engraftment in recipients undergoing allogeneic hematopoietic stem cell (HSC) transplant. Marrow collection centers anticipate the harvest volume required to meet a minimum collection goal of 2 £ 108 TNCs/ kg based on published aggregates of donor marrow TNC concentrations (currently set at 18.3 £ 109/L). However, marrow TNCs are highly variable among marrow donors. We hypothesized that baseline donor characteristics such as age, BMI, and ethnicity, could be used to more accurately predict TNCs. Objectives: We commissioned an IRB-approved retrospective single center study to ascertain which donor characteristics could independently predict marrow TNCs during a harvest as well as the impact on successful recipient engraftment.
S201
Methods: Univariate linear regression was conducted to estimate the crude association between each factor and TNC (487 donors). The following variables were considered as possible predictors: donor BMI, age, ethnicity, gender, and total harvest volume. Variables that had a p value <0.20 in the univariate analysis were entered into a multivariate linear regression model, in which p<0.05 was considered to be statistically significant. Results: Univariate analysis revealed no difference in TNCs between genders (p = 0.697). BMI was significantly positively correlated with TNCs (t = 4.17; p<0.0001). Age was significantly negatively correlated with TNCs (t = -2.76; p = 0.006), as was harvest volume (t = -7.97; p<0.0001). Significant differences (p<0.0001) in TNC counts were also found between ethnicities (Caucasian, Hispanic, Black, Asian, and Native American/ Mixed/Other). Asians (n=39) and AAs (n=71) had lower TNCs (mean 16.217 and 15.8, respectively) than other ethnicities. The multivariate model included BMI, volume, ethnicity, and age, all of which maintained significance in predicting TNC (Table 1). We obtained engraftment (neutrophil recovery) data for 327 recipients. Of donors for non-engrafted recipients (n=11), four were Caucasian, three Hispanic, two Asian, and one Native American/Mixed/Other. We could not demonstrate a significant difference in engraftment by ethnicity, age, nor BMI. Descriptive statistics of the TNC count differences are shown in Table 2. Conclusion: Our findings demonstrate that multiple donor characteristics can predict marrow TNCs. The impact of ethnicity on marrow TNC counts, but not on engraftment rates, suggests that the true HSC concentrations might be higher in these donors despite the lower TNCs. As donor pools diversify and use of haploidentical donors increases, our observations indicate that expected TNC counts during marrow harvests will vary based on baseline donor characteristics.
Table 1 Results from the multivariate model of significant predictors of TNC count
Table 2 Mean TNC differences among donor characteristics