Differences between graft product and donor side effects following bone marrow or stem cell donation

Abstract

Summary:We report graft product stem cell yields and donor safety results of a randomized multicenter study comparing allogeneic peripheral blood stem cell (PBSC) PBSC transplantation with BM transplantation. Matched HLA-identical sibling donors (n ¼ 329) were randomized to filgrastim-mobilized PBSC or bone marrow (BM) donation groups. Median yields per kg recipient weight of CD34 þ cells, T cells, and natural killer (NK) cells, respectively, were approximately two-fold, eight-fold, and greater than eight-fold in the PBSC group than in the BM group (CD34 þ cells, 5.8 Â 10 6 /kg vs 2.7 Â 10 6 /kg; T cells, 300.1 Â 10 6 /kg vs 35.7 Â 10 6 /kg; NK cells, 28.2 Â 10 6 /kg vs 3.6 Â 10 6 /kg; Po0.001 for each). In connection with the cell collection procedures, PBSC donors spent a shorter median time in hospital than BM donors (0 vs 2 days; median difference À2 days, 95% CI À2 to 2) and had fewer median days of restricted activity (2 vs 6 days; median difference À3 days, 95% CI À4 to 2). Overall, 65% of PBSC donors and 57% of BM donors reported at least one adverse event (AE), most of which were transient, mild-moderate in severity, and without clinical sequelae. PBSC donors experienced predominantly filgrastim-related AEs, while BM donors experienced predominantly harvest-related AEs.

Regeneration, health status and quality of life after rhG-CSF-stimulated stem cell collection in healthy donors: a cross-sectional study

“…26 In line with earlier observations, we found a significantly lower CD34 þ cell concentration in the products of female than that in male donors, irrespective of the donor's age (Po0.05). 3,26 In our study, we could not confirm the observation of Suzuya et al 27 who found a negative correlation between donor's age, CD34 mobilization capacity and yield. This can be best explained by the fact that the investigated cohort of donors in our study was older than the donors described by Suzuya et al, 27 with a median age of 41 years (range 11-72), and only two were younger than 18 years.…”

“…3,26 Beside recipient variables (for example, body weight and required CD34 amount), the concentration of CD34 þ cells in the peripheral blood of donors is predictive for estimation of the number of procedures. 26 In line with earlier observations, we found a significantly lower CD34 þ cell concentration in the products of female than that in male donors, irrespective of the donor's age (Po0.05).…”

“…2 PBPCs have been shown to be superior to BMderived stem cells during the early post transplant course. 3,4 The high CD34 þ cell yield in PBPC grafts significantly shortens the post transplant aplasia and the need for blood component support, especially platelets. 3,4 Nowadays, rhG-CSF for the mobilization of PBPCs in stem-cell donors is common, but dosage and frequency of application are still inconsistent.…”

G-CSF-primed bone marrow as a source of stem cells for allografting: revisiting the concept

“…48 Anecdotal reports have been published describing the development of leukemia after G-CSF-primed PBSC donation. [49][50] However, three small studies of normal adult PBSC donors did not show clinically significant changes in white cell numbers and no donor leukemia was noted. [51][52][53] In a recent analysis, 203 healthy volunteer donors were followed up actively for 5 years after G-CSF-mobilized PBSCs were collected.…”

Allogeneic hematopoietic stem cell donation—standardized assessment of donor outcome data: A consensus statement from the Worldwide Network for Blood and Marrow Transplantation (WBMT)

“…Smaller studies from related donors suggest that these frequent side effects occur with the same pattern in related donors. [12][13][14][15] Sporadic case reports and a recent large survey among transplant teams demonstrate that the donation procedure can be associated with a small but real risk for serious adverse events and reactions (SAE/R). [16][17][18][19] Current experience suggests that risks seem to be higher for related than for unrelated donors with the caveat of reporting bias and lack of an adequate amount of prospective follow-up data in the related donor setting.…”