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Declining bone marrow harvest quality over 24 years: a single institution experience

Bone Marrow Transplantation volume 56, pages 983–985 (2021)Cite this article

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The collection or harvesting of bone marrow for hematopoietic cell transplantation (HCT) has been practiced widely since the 1970s [1]. The subsequent demonstration that filgrastim mobilized peripheral progenitor cells collected via apheresis (HPC-A) could avoid harvest related morbidity and, in some situations, result in superior recipient outcomes, led to preference for HPC-A progenitor cells [2]. A Clinical Trials Network (CTN) study, however, showed a significantly increased risk of chronic graft-versus-host disease with transplants using HPC-A compared to bone marrow (HPC-M) after myeloablative matched unrelated donor transplantation [3].

The practice of bone marrow harvesting was described by Dr. E. Donnall Thomas in a review on bone marrow transplantation 1975 [1]. Multiple bone marrow aspirations from the iliac crests with limitation of each aspiration to 1–3 ml to avoid excessive contamination by blood, was described. Subsequent studies have shown that nucleated cell counts and CFU-GM are lower with increasing peripheral blood contamination [4, 5]. While similar harvest practices have been described at other centers, the limited volume of each aspiration and the number of skin puncture (or iliac crest puncture) sites have been variable. With the increasing preference for HPC-A, most transplant centers have performed progressively fewer harvests over the last two decades. With fewer requested harvests, physician, and other practitioner training and experience with the procedure have undoubtedly diminished.

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Fig. 1: Box plot of TNC by era.
Fig. 2: Box plot of product volume by era.

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Author notes

  1. Rachel Cohen

    Present address: Hartford HealthCare, Hartford, CT, USA

  2. Richard Mathews

    Present address: New York Blood Center, New York, New York, NY, USA

Authors and Affiliations

  1. Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital, Boston, MA, USA

    Thomas R. Spitzer, Rachel Cohen, Richard Mathews, Steven L. McAfee, Bimalangshu R. Dey, Areej El-Jawahri, Zachariah DeFilipp, Matthew Frigault, Paul O’Donnell, Chrisa Hunnewell, Meredith Saylor, Julie Vanderklish, Colleen Danielson, Cathleen Poliquin & Yi-Bin Chen

  2. Dana Farber Cancer Center, Boston, MA, USA

    Se Eun Kim & Shuli Li

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Correspondence to Thomas R. Spitzer.

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Spitzer, T.R., Kim, S.E., Cohen, R. et al. Declining bone marrow harvest quality over 24 years: a single institution experience. Bone Marrow Transplant 56, 983–985 (2021). https://doi.org/10.1038/s41409-020-01143-3

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