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Analysis of the CD34+ cell to total nucleated cell content ratio of 619 transplanted and back-up cord blood units

Bone Marrow Transplantation volume 56, pages 701–704 (2021)Cite this article

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Cord blood (CB) is an important alternative stem cell source that extends transplant access to all patients, especially racial and ethnic minorities [1, 2]. Careful CB unit selection is critical to optimize engraftment and survival after CB transplantation (CBT) [3, 4]. While the total nucleated cell (TNC) dose is the traditional measure of progenitor content, the CD34+ cell dose of a CB unit is the most critical determinant of engraftment [3,4,5,6,7]. Therefore, both TNC and CD34+ cell doses should be considered in unit selection [3, 4]. However, the correlation between the TNC and CD34+ cell contents of banked units is weak [8]. Consequently, many units with an adequate or even high TNC count may have intermediate or low CD34+ cell content. Differences in unit processing and cryopreservation practices, as well as a lack of strict standardization of precryopreservation CD34+ cell enumeration may partially account for this observation [9]. Finally, units may rarely be listed with an unexpectedly high CD34+ cell content which reflects erroneous data entry.

Knowledge of the expected CD34+ cell to TNC (CD34+/TNC) content ratio would be useful to identify “out-of-range” CD34+ cell values that should be confirmed before final graft selection is performed. A median CD34+/TNC content ratio of 0.34% (IQR: 0.23%–0.48%) has been reported in an analysis of the United States inventory of over 126,000 units [8]. However, the CD34+/TNC content ratio of units selected for transplantation at a center that incorporates both TNC and CD34+ doses in its unit selection algorithm has not been reported.

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Fig. 1: CD34+ cell to TNC content (CD34+/TNC) ratio in units selected for adult CBT recipients at MSKCC between 2014 and 2019.

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Acknowledgements

This research was supported in part by a grant from the National Institute of Health, National Cancer Institute (P30 CA008748).

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Authors and Affiliations

  1. Department of Medicine, Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ioannis Politikos, Christopher M. Mazis, Kristine A. Naputo, Kelcey Skinner, Melissa Nhaissi, Eric Davis & Juliet N. Barker

  2. Weill Cornell Medical College, New York, NY, USA

    Ioannis Politikos, Andromachi Scaradavou & Juliet N. Barker

  3. Stem Cell Transplantation and Cellular Therapies, MSK Kids, New York, NY, USA

    Andromachi Scaradavou

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Contributions

IP, AS, and JNB designed the study, analyzed the data, and wrote the paper. IP performed the statistical analysis. CMM, KAN, KS, MN, and ED collected and analyzed the data. All authors reviewed and approved the final version of the paper.

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Correspondence to Ioannis Politikos.

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Conflict of interest

IP has received an educational grant from Merck and serves on a Data and Safety Monitoring Board (DSMB) for ExCellThera. AS has served as the Medical Director at the New York Blood Center/National Cord Blood Program and serves on a DSMB for ExCellThera. JNB has received clinical trial funding from Angiocrine Bioscience and unrestricted educational grants from Gamida Cell and Merck. The authors have no other relevant conflicts of interest to declare.

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Politikos, I., Mazis, C.M., Naputo, K.A. et al. Analysis of the CD34+ cell to total nucleated cell content ratio of 619 transplanted and back-up cord blood units. Bone Marrow Transplant 56, 701–704 (2021). https://doi.org/10.1038/s41409-020-01042-7

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