Gelofusine: A new tool for Erythrosedimentation

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment for various hematopoietic diseases. ABO incompatibility occurs in approximately 30%-40% of allogeneic HSCTs and is classified as major, minor, or bidirectional. A significant risk of ABO-incompatible transplants is immediate hemolysis, which is why RBC depletion is the gold standard for avoiding this complication. Gelofusine, a colloidal solution based on succinyl gelatin, was recently validated by our laboratory as a washing solution for cryopreserved hematopoietic stem cells (HSCs) (Nappo et al., Transfusion 2025; 65(6):1101-1110). Our study aims to evaluate Gelofusine as a novel, rapid, and manual method for RBC depletion. STUDY DESIGN AND METHODS: The sedimentation procedure was performed on 30 units of cord blood considered unsuitable for transplantation; colloidal solution is added in a stoichiometric ratio. The mixture was gently mixed in sterile conditions and sedimentation occurred at room temperature. The process was carried out at different times until the complete sedimentation in two different components: erythrocytes and supernatant. For each unit, leukocyte recovery (WBCs recovery) and erythrocyte depletion (RBCs depletion) were calculated. Statistical analysis was performed using a one-way ANOVA test. RESULTS: WBCs recovery was 79% ± 12, and RBCs depletion was 90% ± 5. Sedimentation time statistically significantly influenced WBCs recovery (p-value ≤.02) but not RBCs depletion. Comparison with HES solution has shown a significantly different (79 vs. 66)% regarding WBC recovery. CONCLUSION: Gelofusine represents a valid alternative to automated systems for carrying out erythrodepletion.