ROUTINE CULTURES OF BONE-MARROW AND PERIPHERAL STEM-CELL HARVESTS - CLINICAL IMPACT, COST-ANALYSIS, AND REVIEW

The American Association of Blood Banks requires routine culture of he matopoietic progenitor cells prior to bone marrow transplantation. We sought to evaluate the cost of that requirement and the incidence and clinical significance of positive cultures. We performed a retrospecti ve analysis of transplant recipients at our institution. Of the 605 pa tients for whom 1,934 consecutive cultures of harvests were done betwe en December 1992 and February 1996, 11 had positive cultures. Six pati ents received a culture-positive harvest with no adverse effects. The total cost of cultures was $35,650 (U,S, $). In North America and worl dwide in 1995, routine culture of harvests would have prevented 7.9 an d 18.9 cases of bacteremia, respectively, at a cost of $95,000 per bac teremia prevented. We conclude that routine culture of hematopoietic p rogenitor cells yields low rates of positivity and that infusion of co ntaminated harvests rarely results in clinically adverse outcomes.