POSTER - #PI1019

A statistical analysis on the relationship of combining multiple variables and fibroblast colony-forming units in bone marrow aspiration

Mourad Mekaouche1*, Medical Office Bio-Orthopaedic and Rehabilitation, Oran, Algeria
Jordan Lewis, OMS-II, Edward Loniewski, D.O., FACOS, FAOAO* *Cellular Healing
College of Osteopathic Medicine, Michigan State University, East Lansing, MI 

Introduction
Critical minimal fibroblast colony-forming units (CFU-f) levels are necessary to predict success of musculoskeletal conditions such as osteoarthritis of the knee , rotator cuff 1 tears , degenerative disc disease, and non-unions. CFU-f results normally 2 3 4 take between 10-14 days to complete. Total nucleated counts (TNC) are a quick, accurate process performed bedside in a matter of minutes. Previous studies show moderate correlations between TNC and Mesenchymal Stem Cell (MSC) counts or 5 CFU-f as well as age of the patient and harvest techniques. No previous studies have 67 correlated a combination of these multiple variables to predict the CFU-f.

Purpose
Combining the variables of age, aspiration technique and TNC will provide a reliable correlation to CFU-f counts at the time of bone marrow harvest allowing for a predictive bedside model on the volume of bone marrow harvest required to deliver the critical minimal level of CFU-f.

Methods
Over 53 bone marrow iliac crest aspirations from multiple clinic sites were submitted for TNC, viability and CFU-f analysis. Results were compared to a predictive model combining age, TNC, and viability. Further refinement was made using average recovery rates with the ART BMC system (Celling Biosciences, Austin, TX) as well as segregating the harvesting techniques between
4-6 cc per aspiration within a 10 cc syringe. Statistical analysis was run using the Spearman's rank order correlation test.

Results
• Moderate to high Spearman's correlation coefficient between the actual and predicted CFU-fs/mL were found.
• One physician submitted 32 BMC samples providing a coefficient of 0.91 for the actual BMC CFU-f and BMC TNC, and a coefficient of 0.83 for the actual BMC CFU-f and predicted BMC CFU-f.
• Another physician with 22 samples provided CFU-f and predicted BMA CFU-f of 0.64, while the coefficient for the actual BMA CFU-f and BMA TNC was 0.76.

Conclusions
• Our current predictive model combining age, aspiration technique and TNC provides a strong correlation coefficient providing a reliable bedside method to predict the amount of bone marrow aspirate necessary to produce a clinically relevant CFU-f dosing.

References
Hernigou P. Subchondral stem cell therapy versus contralateral total knee arthroplasty for osteoarthritis following secondary osteonecrosis of the knee. 2Hemigou P. Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: a case-controlled study 3Pattine KA. Autologous bone marrow concentrate intradiscal injection for the treatment of degenerative disc disease with three-year follow-up. 4Hernigou P. Single-stage treatment of infected tibial non-unions and osteomyelitis with bone marrow granulocytes precursors protecting bone graft 5Bouwmeester W. Prediction of nucleated cells in bone marrow stem cell products by donor characteristics: a retrospective single center analysis 6Baxter MA. Study of telomere length reveals rapid aging of human marrow stromal cells following in vitro expansion. 'Hemigou P. Benefits of small vohune and small syringe for bone marrow aspirations of mesenchymal stem cells