Evaluation of peripheral blood stem cell collection in the Japan Marrow Donor Program (JMDP)
Rie Yamazaki1, Kimikazu Yakushijin2, Satoshi Yoshihara3,4
1Center for Transfusion Medicine and Cell Therapy, Keio University Hospital, Shinjuku-ku, Japan.
Background:
For peripheral blood stem cell (PBSC) collection of unrelated donors, the Japan Marrow Donor Program (JMDP) sets the target CD34+ cell dose as the minimum of 2 × 106 cells/kg of recipient body weight (RBW) and recommends a processing blood volume (PBV) as high as 200 mL/kg of donor body weight (DBW) with ≤250 mL/kg per day within two consecutive days. Here, we retrospectively reviewed this guideline.
Study Design And Methods:
We analyzed 1656 unrelated donor PBSC collections between January 2012 and November 2022 from the JMDP database.
Results:
The target CD34+ cell dose was achieved within 2 days in all but 40 cases (2.4%), suggesting that the current JMDP guideline largely meets its objectives. The distribution of PBV per DBW showed three peaks. The most prominent peak, consisting of 834 (50.4%) cases, occurred around the recommended PBV (180-220 mL/kg of DBW), whereas 659 (39.8%) cases were in the lower PBV range (<180 mL/kg), and, notably, there was no significant difference between these groups in the collected CD34+ cells/kg RBW. On the other hand, among the 163 (9.8%) cases in the higher PBV group (>220 mL/kg), the number of collected CD34+ cells/kg of RBW was significantly lower than in the other two groups.
Discussion:
These results suggest that the target PBV in the lower and higher PBV groups was determined using CD34+ enumeration before or during apheresis procedure. CD34+ enumeration may help reduce the burden on donors, although further investigations are needed to confirm.
