The actual usefulness of culturing apheresis products in hematopoietic stem cell autotransplants.

Abstract

Abstract Background: Bacterial cultures of the apheresis products for autologous hematopoietic stem cell transplants (aHSCT) are mandatory in most institutions worldwide; even the FACT-Jacie standards include them. Culture results are frequently obtained after the reinfusion of HSCT to patients, thus questioning their practical value. Objective: To analyze the results of bacterial cultures in a group of 629 apheresis products obtained in 4 years, in persons given aHSCT in a single institution, and based on schedules using non-frozen HSCT. Methods: Bacterial cultures of apheresis products aliquots were prospectively obtained in all persons who received an aHSCT at the Centro de Hematología y Medicina Interna de Puebla, after 2021. The timing of reinfusion of the products was analyzed, as well as the 28-day outcome of individuals managed with an aHSCT. Results: Six hundred twenty-nine apheresis products were administered to 586 patients and were prospectively analyzed. Thirty-eight persons received two apheresis products, and five received three. The cultures of the aliquots were positive in 8/629 (1.3%). In one case, the result of the culture was obtained within the first 24 hours after apheresis: it revealed the presence of E. coli, which was also isolated in the urine of the patient who developed fatal sepsis originating in the urinary tract; the apheresis product was discarded. In the other 7 cases, the result of the culture was obtained 1-11 days (median: 6) after the apheresis, and the isolated organisms were: Propionibacterium acnes (6 aliquots), Staphylococcus capitis, and Coryneform bacteria(one aliquot each); two organisms were found in one of the aliquots. The apheresis products had already been administered to the patients once the culture results were obtained. Contamination thus occurred when handling the aliquots. All patients had uneventful recoveries. Conclusion: Bacterial culture of apheresis products provided helpful information in 1/629 aHSCT. Most positive results from the bacterial cultures were due to contamination of the aliquots during manipulation.