Skip to main content
SpringerLink
Log in

Applications of Apheresis Devices in Processing Bone Marrow Grafts

  • Chapter
  • First Online:
Best Practices of Apheresis in Hematopoietic Cell Transplantation

  • 480 Accesses

Abstract

ABO blood groups antigens are inherited independently from the human leukocyte antigen (HLA) system. Thus, up to 50% of allogeneic hematopoietic cell transplantations (HCT) are performed across the ABO blood group barrier. While peripheral blood hematopoietic progenitor cell (HPC) infusion can be performed mostly without any ABO-related complications, the infusion of bone marrow (BM) requires the implementation of safety precautions to avoid acute immune-mediated hemolysis during transplantation. Bone marrow processing techniques to remove either red blood cells (RBCs), or plasma, have been implemented decades ago. As autologous BM grafts have to be cryopreserved and stored in liquid nitrogen or its vapor phase, volume reduction before freezing is a pre-requirement. Over the last decades, various apheresis devices and protocols were developed for this purpose, partly using sedimentation agents or density gradient centrifugation with density gradient reagents to optimize processing results. These substances bear a potential risk for the BM cells and the recipients. In the beginning of the 1990s, apheresis technology was substantially improved. The latest innovations in this field were the Cobe Spectra (Terumo BCT) and Spectra Optia (Terumo BCT). With both devices, optimal results with respect to volume and RBC reduction and progenitor cell and mononuclear cell (MNC) recovery can be achieved. The Amicus (Fresenius) device reveals similar results but lacks a dedicated program for BM processing. Therefore, it should only be used by operators and physicians who are highly experienced with this device. BM collections from very small children may not fulfill the requirements for BM processing by apheresis in terms of minimal BM and RBC volume. In these cases, either RBC units can be added or a special device for cord blood processing (Biosafe Sepax device) can be used. An important issue for optimal progenitor cell and MNC selection by apheresis is a short transit time from the collection to the processing facility. Overnight storages should take place in a refrigerator at 4 °C ± 2 °C.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Anasetti C, Logan BR, Lee SJ, Waller EK, Weisdorf DJ, Wingard JR et al (2012) Peripheral-blood stem cells versus bone marrow from unrelated donors. New Engl J Med 367(16):1487–1496

    Article  CAS  Google Scholar 

  • Babic A, Regan D (2014) Umbilical cord blood banking. American Association of Blood Banks (AABB), Bethesda. 729 p

    Google Scholar 

  • Barnes DWH, Loutit JF (1955) Radiation recovery factor and preservation by the Polge Smith Parkes Parkes technique. J Natl Cancer Inst 15:901–905

    CAS  PubMed  Google Scholar 

  • Berz D, McCormack EM, Winer ES, Colvin GA, Quesenberry PJ (2007) Cryopreservation of hematopoietic stem cells. Am J Hematol 82(6):463–472

    Article  Google Scholar 

  • Booth GS, Gehrie EA, Bolan CD, Savani BN (2013) Clinical guide to ABO-incompatible allogeneic stem cell transplantation. Biol Blood Marrow Transplant 19(8):1152–1158

    Article  CAS  Google Scholar 

  • Curcioli AC, de Carvalho EC (2010) Infusion of hematopoietic stem cells: types, characteristics, adverse and transfusion reactions and the implications for nursing. Rev Lat Am Enfermagem 18(4):716–724

    Article  Google Scholar 

  • Daniele N, Scerpa MC, Rossi C, Lanti A, Adorno G, Isacchi G et al (2014) The processing of stem cell concentrates from the bone marrow in ABO-incompatible transplants: how and when. Blood Transfus 12(2):150–158

    PubMed  PubMed Central  Google Scholar 

  • Daniel-Johnson J, Schwartz J (2011) How do I approach ABO-incompatible hematopoietic progenitor cell transplantation? Transfusion 51(6):1143–1149

    Article  Google Scholar 

  • Davis-Sproul J, Haley NR, McMannis J (2008) Collecting and processing marrow products for transplantation. 16th edition. S Karger AG, Basel. 765 p

    Google Scholar 

  • Falkenburg JH, Schaafsma MR, Jansen J, Brand A, Goselink HM, Zwaan FE et al (1985) Recovery of hematopoiesis after blood-group-incompatible bone marrow transplantation with red-blood-cell-depleted grafts. Transplantation 39(5):514–520

    Article  CAS  Google Scholar 

  • Gajewski JL, Johnson VV, Sandler SG, Sayegh A, Klumpp TR (2008) A review of transfusion practice before, during, and after hematopoietic progenitor cell transplantation. Blood 112(8):3036–3047

    Article  CAS  Google Scholar 

  • Gale RP, Feig S, Ho W, Falk P, Rippee C, Sparkes R (1977) ABO blood group system and bone marrow transplantation. Blood 50(2):185–194

    Article  CAS  Google Scholar 

  • Gilmore MJ, Prentice HG, Blacklock HA, Janossy G, Hoffbrand AV (1982) A technique for rapid isolation of bone marrow mononuclear cells using Ficoll-Metrizoate and the IBM 2991 blood cell processor. Br J Hematol 50(4):619–626

    Article  CAS  Google Scholar 

  • Gonzalez-Campos J, Carmona-Gonzalez M, Rodriguez-Fernandez JM, Mellado-Damas N, de Luis-Navarro J (2000) Bone marrow processing using the fenwal CS-3000 plus blood cell separator: results of 99 procedures. J Hematother Stem Cell Res 9(1):83–88

    Article  CAS  Google Scholar 

  • Guttridge MG, Sidders C, Booth-Davey E, Pamphilon D, Watt SM (2006) Factors affecting volume reduction and red blood cell depletion of bone marrow on the COBE Spectra cell separator before haematopoietic stem cell transplantation. Bone Marrow Transplant 38(3):175–181

    Article  CAS  Google Scholar 

  • Guttridge MG, Bailey C, Sidders C, Nichols J, Bromham J, Watt SM (2016) Human bone marrow processing using a new continuous-flow cell separation device. Transfusion 56(4):899–904

    Article  CAS  Google Scholar 

  • Haemotec. Biosafe Sepax Automated Cell Processing. Operators manual

    Google Scholar 

  • Henig I, Zuckerman T (2014) Hematopoietic stem cell transplantation-50 years of evolution and future perspectives. Rambam Maimonid Med J 5(4):e0028

    Article  Google Scholar 

  • Hester JP, Rondon G, Huh YO, Lauppe MJ, Champlin RE, Deisseroth AB (1995) Principles of bone marrow processing and progenitor cell/mononuclear cell concentrate collection in a continuous flow blood cell separation system. J Hematother 4(4):299–306

    Article  CAS  Google Scholar 

  • Hunt CJ (2011) Cryopreservation of human stem cells for clinical application: a review. Transfus Med Hemother 38(2):107–123

    Article  Google Scholar 

  • Karafin MS, Blagg L, Tobian AA, King KE, Ness PM, Savage WJ (2012) ABO antibody titers are not predictive of hemolytic reactions due to plasma-incompatible platelet transfusions. Transfusion 52(10):2087–2093

    Article  CAS  Google Scholar 

  • Koristek Z, Mayer J (1999) Bone marrow processing for transplantation using the COBE spectra cell separator. J Hematother Stem Cell Res 8(4):443–448

    Article  CAS  Google Scholar 

  • Leemhuis T, Padley D, Keever-Taylor C, Niederwieser D, Teshima T, Lanza F et al (2014) Essential requirements for setting up a stem cell processing laboratory. Bone Marrow Transplant 49(8):1098–1105

    Article  Google Scholar 

  • Leitner GC, Kolovratova V, Horvath M, Worel N (2015) Granulocyte collection using a novel apheresis system eases the procedure and provides concentrates of high quality. Transfusion 55(5):991–995

    Article  CAS  Google Scholar 

  • Linch DC, Knott LJ, Patterson KG, Cowan DA, Harper PG (1982) Bone marrow processing and cryopreservation. J Clin Pathol 35(2):186–190

    Article  CAS  Google Scholar 

  • Mielcarek M, Leisenring W, Torok-Storb B, Storb R (2000) Graft-versus-host disease and donor-directed hemagglutinin titers after ABO-mismatched related and unrelated marrow allografts: evidence for a graft-versus-plasma cell effect. Blood 96(3):1150–1156

    Article  CAS  Google Scholar 

  • Nussbaumer W, Schwaighofer H, Gratwohl A, Kilga S, Schonitzer D, Nachbaur D et al (1995) Transfusion of donor-type red cells as a single preparative treatment for bone marrow transplants with major ABO incompatibility. Transfusion 35(7):592–595

    Article  CAS  Google Scholar 

  • Posel C, Moller K, Frohlich W, Schulz I, Boltze J, Wagner DC (2012) Density gradient centrifugation compromises bone marrow mononuclear cell yield. PLoS One 7(12):e50293

    Article  Google Scholar 

  • Rabitsch W, Knobl P, Greinix H, Prinz E, Kalhs P, Horl WH et al (2003) Removal of persisting isohaemagglutinins with Ig-Therasorb immunoadsorption after major ABO-incompatible non-myeloablative allogeneic haematopoietic stem cell transplantation. Nephrol Dial Transplant 18(11):2405–2408

    Article  Google Scholar 

  • Roback JD, Grossman BJ, Harris T, Hillyer CD (2011) American Association of Blood Banks

    Google Scholar 

  • Rowley SD (1992) Hematopoietic stem cell cryopreservation: a review of current techniques. J Hematother 1(3):233–250

    Article  CAS  Google Scholar 

  • Rowley SD (2001) Hematopoietic stem cell transplantation between red cell incompatible donor-recipient pairs. Bone Marrow Transplant 28(4):315–321

    Article  CAS  Google Scholar 

  • Rowley SD, Liang PS, Ulz L (2000) Transplantation of ABO-incompatible bone marrow and peripheral blood stem cell components. Bone Marrow Transplant 26(7):749–757

    Article  CAS  Google Scholar 

  • Scerpa MC, Daniele N, Landi F, Caniglia M, Cometa AM, Ciammetti C et al (2011) Automated washing of human progenitor cells: evaluation of apoptosis and cell necrosis. Transfus Med 21(6):402–407

    Article  CAS  Google Scholar 

  • Sorg N, Poppe C, Bunos M, Wingenfeld E, Hummer C, Kramer A et al (2015) Red blood cell depletion from bone marrow and peripheral blood buffy coat: a comparison of two new and three established technologies. Transfusion 55(6):1275–1282

    Article  CAS  Google Scholar 

  • TerumoBCT. Cobe Spectra Apheresis Systems. Technical guide

    Google Scholar 

  • TerumoBCT. Spectra Optia® Apheresis System Protocols. Technical guide

    Google Scholar 

  • Warkentin PI, Hilden JM, Kersey JH, Ramsay NK, McCullough J (1985) Transplantation of major ABO-incompatible bone marrow depleted of red cells by hydroxyethyl starch. Vox Sang 48(2):89–104

    Article  CAS  Google Scholar 

  • Wells JR, Sullivan A, Cline MJ (1979) A technique for the separation and cryopreservation of myeloid stem cells from human bone marrow. Cryobiology 16(3):201–210

    Article  CAS  Google Scholar 

  • Witt V, Beiglbock E, Ritter R, Wurth M, Peters C, Ladenstein R et al (2007) Performance of a new separator system for routine autologous hematopoietic progenitor cell collection in small children. J Clin Apher 22(6):306–313

    Article  Google Scholar 

  • Witt V, Beiglbock E, Fritsch G (2011) Bone marrow processing with the AMICUS separator system. J Clin Apher 26(4):195–199

    Article  CAS  Google Scholar 

  • Worel N (2016) ABO-mismatched allogeneic hematopoietic stem cell transplantation. Transfus Med Hemother 43(1):3–12

    Article  Google Scholar 

  • Worel N, Buser A, Greinix HT, Hagglund H, Navarro W, Pulsipher MA et al (2015) Suitability criteria for adult related donors: a consensus statement from the worldwide network for blood and marrow transplantation standing committee on donor issues. Biol Blood Marrow Transplant 21(12):2052–2060

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department for Blood Group Serology and Transfusion Medicine, Medical University Vienna, Vienna, Austria

    Gerda C. Leitner

Authors
  1. Gerda C. Leitner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gerda C. Leitner .

Editor information

Editors and Affiliations

  1. Cancer Treatment Centers of America, Dept Hematology & Bone Marrow Transplantation, Deerfield, IL, USA

    Syed A. Abutalib

  2. BloodCenter of Wisconsin, Milwaukee, WI, USA

    Anand Padmanabhan

  3. Department of Pathology, Keck School of Medicine of USC, Los Angeles, CA, USA

    Huy P. Pham

  4. Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria

    Nina Worel

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Leitner, G.C. (2020). Applications of Apheresis Devices in Processing Bone Marrow Grafts. In: Abutalib, S., Padmanabhan, A., Pham, H., Worel, N. (eds) Best Practices of Apheresis in Hematopoietic Cell Transplantation. Advances and Controversies in Hematopoietic Transplantation and Cell Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-55131-9_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-55131-9_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-55130-2

  • Online ISBN: 978-3-319-55131-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation