Core diameter of bone marrow aspiration devices influences cell density of bone marrow aspirate in patients with severe peripheral artery disease

Background aims: Bone marrow (BM) transplantations are an accepted therapeutic strategy for hematologic conditions. In the past decades, interest for BM-derived cell therapy has extended toward the field of regenerative medicine. Irrespective of the treatment strategy, its success depends on the amount of cells available for transplantation. Both patient and procedural factors have been shown to influence the cell density of the BM aspirate. In the present study, the influence of core diameter of the BM aspiration device on cell density of the BM aspirate is studied. Methods: BM harvesting procedures performed in a clinical trial investigating the effect of BM cell therapy in patients with severe peripheral artery disease were retrospectively studied (clinicaltrials.gov NCT00371371). Patients underwent BM harvesting through the use of either a 15-gauge (n = 85) or an 8-gauge (n = 75) needle. The numbers of harvested white blood cells (WBC) and CD34⁺ hematopoietic cells (HPC) were quantified. Results: The amount of WBC per milliliter of BM aspirate was significantly higher when the 8-gauge needle (27.8 × 10⁶ WBC/mL [95%CI 25.4-30.5 × 10⁶]) was used compared with the smaller 15-gauge core needle (20.1 × 10⁶ WBC/mL [95% confidence interval (CI), 18.7-21.7 × 10⁶], P < 0.001). For the amount of CD34⁺ HPC, a similar pattern was observed (185 × 10³ HPC/mL [95% CI, 161-213 × 10³]; 114 × 10³ HPC/mL [95% CI, 96-134 × 10³]; P < 0.001). Conclusions: The application of a BM aspiration device with a larger core diameter is associated with an increased cell density of the BM aspiration product in patients with severe peripheral artery disease.