We tested the Marrow Cellutions/Maxx Regen Needle on the left posterior iliac crest against a multiport Jamshidi Needle on the right posterior iliac crest (same patient) used in a unicortical, multi-depth technique.
Technique #1: The Marrow Cellutions Needle used a 10 cc syringe and 1cc draws per aspiration, starting about 4.5cm deep in the left posterior iliac crest…..with each 1cc aspiration being about 0.4cm – 0.5cm more superficial than the previous one.
Technique #2: A Multiport Jamshidi Needle was initially placed 1.5 cm into the right posterior iliac crest. 6cc of marrow was drawn into a 10 cc syringe that held about 1 cc of heparin. The needle was then rotated 90 degrees and another 6cc of marrow was drawn into a new 10cc syringe also preloaded with 1cc of heparin. The stylus was then replaced and the needle advanced 0.5cm. At this new depth, the aspiration process was duplicated….resulting in another 12cc of marrow + 2cc of heparin. This was repeated again 0.5cm deeper….and again until we had a total of 48cc of bone marrow aspirate combined with 7cc of heparin to make a total of 55cc to centrifuge in the disposable
The Total Nucleated Cell Count on the Marrow Cellutions 9cc marrow aspiration product was 21.1 million/ml for a total of 189.9 million. The CFU-f/ml on the end product was 464/ml
The Total Nucleated Cell Count on the 55cc bone marrow aspiration was 10 million/ml for a total of 550 million. The CFU-f/ml on the pre-concentrate aspiration was 200/ml
The Total Nucleated Cell Count on the 8cc bone marrow concentrate product was 40.2 million/ml for a total of 321.6 million. The CFU-f/ml on the post concentrate end product was 1628/ml.
SUMMARY:
Round 2 was designed to test is if the Marrow Cellutions/Maxx Regen Needle could provide a higher CFU-f/ml count than a technique where more marrow is aspirated and then centrifuged to get the end product. The aspirations were done on the same patient on opposite iliac crests.
The Marrow Cellutions Needle aspiration provided a higher TNC count for an 8ml aspiration compared to the TNC count from a multiport Jamshidi unicortical, multidepth aspiration of 55ml. The syringe sizes were the same but the amount of marrow drawn was different per aspiration.
The CFU-f/ml count on the final Marrow Cellutions product was 464/ml.
Author’s impression: Drawing marrow 1 cc at a time with good technique at different depths should beat drawing marrow 6 cc at a time at different depths in a unicortical technique… if everything else is held equal. The Marrow Cellutions needle did give a higher TNC count and CFU-f/ml count than a 55cc aspiration done with the UPICA technique prior to centrifuging and concentration and RBC removal.
The ultrasound guided posterior iliac crest (UPICA) technique uses a multi-port Jamshidi and aspirations are done at progressively deeper depths with 6cc draws per 10cc syringe used. 2 draws are done at each depth.
The CFU-f/ml count on the UPICA post filtered, centrifuged and concentrated product was CFU-f/ml of 1628/ml.
The act of centrifuging and concentrating a 55 cc marrow aspiration provided significantly higher CFU-f/ml than that obtained with the 8cc marrow aspiration done with the Marrow Cellutions Needle.
The increase in CFU-f/ml obtained was 3.5X higher by drawing 55cc of marrow instead of just 8cc and then filtering and centrifuging the marrow to create a buffy coat.
The two end products may be compared on other metrics besides TNC and CFU-f/ml but I chose these two because of how bone marrow stem cell solutions are most commonly marketed to clinicians. There may or may not be other advantages to using unfiltered bone marrow aspiration over filtered and concentrated (RBCs removed) bone marrow concentrate…but this test wasn’t designed to evaluate RBC content or growth factor or cytokine content.
Stay Tuned for Round 3!
The CFU-f/ml results from Round 2 are in!
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