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A double buffy coat method for red cell removal from ABO-incompatible marrow
C S Rosenfeld1, H Tedrow, F Boegel
1Department of Medicine, Montefiore Hospital, Pittsburgh, Pennsylvania.
Transfusion
|June 1, 1989
Summary
A novel double buffy coat technique effectively removes incompatible red blood cells from bone marrow transplants, preventing hemolytic reactions. This method ensures safe engraftment in ABO-incompatible marrow procedures.
Area of Science:
- Hematology
- Transplantation Immunology
- Cellular Therapy
Background:
- Transfusion of ABO-incompatible bone marrow can lead to dangerous hemolytic reactions.
- Current methods to prevent these reactions include reducing recipient isohemagglutinins or depleting incompatible red cells from donor marrow.
Purpose of the Study:
- To describe a rapid and reliable method for removing incompatible red blood cells from harvested bone marrow using a blood cell processor.
- To evaluate the efficacy and safety of the double buffy coat technique in ABO-incompatible allogeneic bone marrow transplantation.
Main Methods:
- A double buffy coat technique was employed on a blood cell processor to deplete incompatible red cells from donor marrow.
- The method was tested in five allogeneic bone marrow transplant cases involving ABO-incompatible marrow.
Main Results:
- The maximum volume of transfused incompatible red cells was 8.8 ml, with no observed hemolytic transfusion reactions in any patient.
- Median nucleated cell recovery was 77%, and progenitor cell recovery was 104%.
- Engraftment was achieved at a median of 13 days post-transplantation.
Conclusions:
- The double buffy coat method is an effective and acceptable technique for processing ABO-incompatible bone marrow.
- This technique successfully mitigates the risk of hemolytic transfusion reactions in ABO-incompatible marrow transplantation.