Acute toxicities of unrelated bone marrow versus peripheral blood stem cell donation: results of a prospective trial from the National Marrow Donor Program

Author:

Pulsipher Michael A.1,Chitphakdithai Pintip2,Logan Brent R.3,Shaw Bronwen E.4,Wingard John R.5,Lazarus Hillard M.6,Waller Edmund K.7,Seftel Matthew8,Stroncek David F.9,Lopez Angela M.10,Maharaj Dipnarine11,Hematti Peiman12,O'Donnell Paul V.13,Loren Alison W.14,Leitman Susan F.9,Anderlini Paolo15,Goldstein Steven C.16,Levine John E.16,Navarro Willis H.217,Miller John P.17,Confer Dennis L.217

Affiliation:

1. Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City, UT;

2. Center for International Blood and Marrow Transplant Research, Minneapolis, MN;

3. Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI;

4. Anthony Nolan Research Institute, London, United Kingdom;

5. LifeSouth Community Blood Centers, Gainesville, FL;

6. University Hospitals Case Medical Center, Ireland Cancer Center, Cleveland, OH;

7. Emory University Hospital, Atlanta, GA;

8. CancerCare Manitoba, University of Manitoba, Winnipeg, MB;

9. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD;

10. Cedars-Sinai Medical Center, Los Angeles, CA;

11. Bethesda Health City, Boynton Beach, FL;

12. University of Wisconsin Hospital and Clinics, Madison, WI;

13. Fred Hutchinson Cancer Research Center, Seattle, WA;

14. Abramson Cancer Center, University of Pennsylvania Medical Center, Philadelphia. PA;

15. The University of Texas MD Anderson Cancer Center, Houston, TX;

16. The University of Michigan, Ann Arbor, MI; and

17. National Marrow Donor Program, Minneapolis, MN

Abstract

Abstract Although peripheral blood stem cells (PBSCs) have replaced bone marrow (BM) as the most common unrelated donor progenitor cell product collected, a direct comparison of concurrent PBSC versus BM donation experiences has not been performed. We report a prospective study of 2726 BM and 6768 PBSC donors who underwent collection from 2004 to 2009. Pain and toxicities were assessed at baseline, during G-CSF administration, on the day of collection, within 48 hours of donation, and weekly until full recovery. Peak levels of pain and toxicities did not differ between the 2 donation processes for most donors. Among obese donors, PBSC donors were at increased risk of grade 2 to 4 pain as well as grade 2 to 4 toxicities during the pericollection period. In contrast, BM donors were more likely to experience grade 2 to 4 toxicities at 1 week and pain at 1 week and 1 month after the procedure. BM donors experienced slower recovery, with 3% still not fully recovered at 24 weeks, whereas 100% of PBSC donors had recovered. Other factors associated with toxicity included obesity, increasing age, and female sex. In summary, this study provides extensive detail regarding individualized risk patterns of PBSC versus BM donation toxicity, suggesting donor profiles that can be targeted with interventions to minimize toxicity.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference23 articles.

1. Recovery and safety profiles of marrow and PBSC donors: experience of the National Marrow Donor Program.;Miller;Biol Blood Marrow Transplant,2008

2. Unrelated hematopoietic stem cell donors as research subjects.;King;Bone Marrow Transplant,2011

3. Donor safety: the role of the WMDA in ensuring the safety of volunteer unrelated donors: clinical and ethical considerations.;Shaw;Bone Marrow Transplant,2010

4. Adverse events among 2408 unrelated donors of peripheral blood stem cells: results of a prospective trial from the National Marrow Donor Program.;Pulsipher;Blood,2009

5. Health-related quality-of-life among adult matched unrelated stem cell donors: a Blood and Marrow Transplant Clinical Trials Network (BMT CTN) randomized trial of marrow versus PBSC donation [abstract].;Switzer;Blood (ASH Annual Meeting Abstracts),2010

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