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Transfusion. 2019 Feb;59(2):681-685. doi: 10.1111/trf.15080. Epub 2018 Dec 7.

Nucleated red blood cells as a novel indicator of CD34+ cell content in umbilical cord blood.

Author information

1
Cell Therapy Laboratory, San Diego Blood Bank, San Diego, California.

Abstract

BACKGROUND:

Umbilical cord blood (UCB) has become an important source of transplantable CD34+ hematopoietic progenitor cells. Cord blood banks (CBBs) can increase their efficiency by minimizing the processing of UCB units with low CD34+ content, which have a lower likelihood of transplant utilization. We sought to identify a readily available preprocessing metric that would correlate with CD34+ cell counts, without the cost of additional analysis.

STUDY DESIGN AND METHODS:

Data were compiled for 131 UCB units processed at the regional CBB. Preprocessing hematologic metrics, including complete blood count and differential, were compared to postprocessing CD34+ cell quantities. The data were divided into six groups of varying preprocessing metrics, then compared for significant differences in postprocessing CD34+ cell quantities to develop a screening guidance.

RESULTS:

UCB units with nucleated RBC (nRBC) content of 15% or greater were found to have a significant increase in CD34+ cell percentage (p < 0.00001) and total CD34+ cell content (p < 0.0001). Units with preprocessing total nucleated cell count (TNC) of ≥ 1.50 × 109 with nRBC content of 15% or greater, and for TNC ≥ of 2.00 × 109 with nRBC content less than15%, had a significant increase in CD34+ content (p < 0.05 and p < 0.001, respectively). Applied as a screening guideline, these units had an increase in mean CD34+ content from 6.24 × 106 to 9.27 × 106 . Units originally in the bottom and top quartiles of CD34+ content constitute 5% and 53% of processed units meeting these TNC/nRBC criteria, respectively.

CONCLUSION:

These screening criteria utilizing nRBC provides a guideline that public CBBs may use to increase their efficiency by minimizing the processing of UCB units with lower CD34+ cell content.

PMID:
30537299
DOI:
10.1111/trf.15080

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