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Background & Aim Background Microbial contamination (+MC) is a complication of bone marrow harvestS. However, risk factors for +MC and implications for recipients are not well-defined. Clinical interventions after +MC range from observation to antimicrobial therapy. Methods, Results & Conclusion Methods We report a retrospective review of 91 pediatric and 101 adult related-donor marrow harvests from Jan 2015 to Mar 2019. Harvests were performed at Boston Children's Hospital (pedi) or Brigham & Women's Hospital (adult) under general anesthesia. Donors received no systemic antimicrobials, just topical sterilization. Samples were cultured in BacT systems and incubated for 14 days at 35°C. Results 19.4% of harvested products from pedi and 24.8% from adult donors demonstrated ≥ 1 +MC result. Mean donor age, weight, gender, and volume harvested differed between pedi and adult donors: 12 vs 40yr, 45.2 vs 79.4kg, male 47% vs 65%, and 622 vs 1200mL. 37% and 39% of products underwent manipulation, respectively (Table 1). Mean time to detection was 4.7 and 6.1 days after pedi and adult harvests. 7.5% and 5.0% of harvests, respectively, yielded +MC ≤ 2 days; 11.8% and 5.9% by 5 days after harvest. Organisms isolated were P. acnes (n=29), Coag-negative Staphylococcus (n=13) and one other Propionibacterium species (n=1). We examined potential risk factors for + MC such as length of harvest (invasive harvesting time); donor age, weight and gender; manipulation; and cell yield (Table 2). In pediatric harvests, +MC correlated with donor age (19 vs 10yr, p Response to positive cultures was at attending physician discretion. Only 9.3% of recipients of a +MC marrow had antimicrobial therapy added, with no product-transmitted infection seen. Neutrophil and platelet engraftment did not differ between +MC vs No Growth marrow recipients. Rates of infusion reactions were within historical norms (19% adult and 11% pedi) and not impacted by +MC. Analyses of donor AEs and +MC unrelated donor harvests are ongoing. Conclusions +MCs are common after pediatric and adult donor harvests. Risk factors may include longer harvest time and higher donor weight but are not clearly modifiable. Despite this +MC incidence, medical implications for recipients and donors after +MC with routine skin flora are few.

Introduction With rapidly increasing demand, resources at cellular therapy centers may be stretched thin. Apheresis and processing lab facilities must meet increased collection, processing, and storage requests, necessitating efficiency. We queried the field's practice of collecting autologous stem cells for 2 transplants in adult multiple myeloma (MM) patients under 65 for efficiency and clinical relevance as MM collections consume significant cell therapy resources. Methods Data points from 2012, 2014, and 2016 for MM patients at DFCI were reviewed: percentage of patients who received first and second transplants after autologous collection, days of collection, and excess hematopoietic progenitor cell HPC(A) bags in cryostorage. MM clinician leadership discussed existing guidelines and clinical rationale for HPC(A) collection targets. After changes implemented in Feb. 2018, collection and storage data was compiled to assess impact. Apheresis & Cell Storage Data Prior to Change From Jul. to Dec. 2017, MM patients Clinical Practice Patterns & Change in Guidelines Before Feb. 2018, autologous MM collection target for patients Apheresis & Cell Storage Results Following Change Between Feb. – Jul. 2018, the total collection days for adult autologous MM patients Conclusion Reducing autologous collection targets for MM patients