Experiences of the first 493 unrelated marrow donors in the National Marrow Donor Program

Abstract

More than 410,000 people participated in the National Marrow Donor Program (NMDP) as of October 1, 1991, and more than 850 volunteers had donated marrow. While the incidence of serious morbidity as a result of bone marrow donation is rare, the incidence of lesser complications and the long-term consequences of marrow donation are not known. To determine the incidence of donor complications and measure the recovery time of volunteer, unrelated marrow donors, we analyzed the results of surveys of the first 493 persons who donated marrow through the NMDP. The marrows were collected at 42 centers. The median age of the donors was 37.9 years (range 19.1 to 55.6 years). The median volume of marrow collected was 1,050 mL (range 180 to 2,983 mL). Autologous red blood cells were transfused to 89.8% (439) of donors but only 0.6% (3) of donors received allogeneic blood. Acute complications related to the collection procedure occurred in 5.9% of donors; but a serious complication, apnea during anesthesia, occurred in only one donor. When donors were questioned approximately 2 days following discharge from their hospitalization, most donors described symptoms related to the collection; 74.8% experienced tiredness, 67.8% experienced pain at the marrow collection site, and 51.6% of the donors experienced low back pain. Donors were surveyed repeatedly until they felt that they had recovered completely. Mean recovery time was 15.8 days; however, 42 (10%) donors felt that it took them > or = 30 days to recover fully. The duration of the marrow collection procedure and duration of anesthesia both positively correlated with donor pain and/or fatigue following the collection; but the duration of the collection procedure had the highest correlation with post-collection pain and fatigue. The volume of marrow collected per unit of donor weight was more weakly correlated with donor pain and/or fatigue than the anesthesia and collection times. When multivariate analysis was used to analyze the correlation between donor recovery time and these variables, only the duration of the collection was found to correlate significantly with donor recovery time (P = .001). This analysis demonstrates that marrow donation is well tolerated with few complications. To decrease further the incidence of donor discomfort and recovery time following donation, the duration of the collection procedure, and probably the duration of anesthesia, and the volume of marrow collected, should be kept to a minimum.

Decreased Opioid Consumption in Bone Marrow Harvest Patients Using Quadratus Lumborum Blocks in a Standardized Protocol

“…In the PACU, only two patients received intravenous opioids. These patients underwent longer harvests with larger total harvest volumes, which can increase postoperative pain ( 9 ). Interestingly, both patients underwent general anesthesia with an endotracheal tube and supplemental ketamine infusions.…”

A Child as a Donor for Hematopoietic Stem Cell Transplantation: Bioethical Justification—A Case Study on Sickle Cell Disease

“…Bone marrow collection could be performed under general anesthesia through multiple punctures to the posterior iliac crest, with low risk of severe adverse events [ 14 , 19 , 20 ].…”

Stem cell bioprocessing: fundamentals and principles

“…For transplantation, this leads to faster myeloid and lymphoid recovery facilitating engraftment and full T-cell chimerism (Sheridan et al 1992;Bensinger et al 1993;Chao et al 1993). Additionally, irrespective of the small inherent risks involved with mobilized PB collection and the use of G-CSF (Martinez et al 1996(Martinez et al , 1999Majolino et al 1997;Tabilio et al 1997;de la Rubia et al 1999) considerably greater in comparison (Buckner et al 1984;Stroncek et al 1993;Pulsipher et al 2006). For bioprocessing, however, the greater volume of cells is offset by their lower expansion capability, making PB HSCs less amenable than bone marrow-derived stem cells.…”