Predonation Health-Related Quality of Life Scores Predict Time to Recovery in Hematopoietic Stem Cell Donors

Abstract

The physical reactions to hematopoietic stem cell donation have been extensively studied, but less is known about factors that predict poorer donation experiences. The aim of this prospective study was to examine demographic and health-related quality of life (HRQOL) factors that might be associated with recovery and side effects. We also described the changes in HRQOL during the donation process. In total, 275 peripheral blood stem cell (PBSC) and 37 bone marrow (BM) consecutive donors completed the SF-36 questionnaire predonation and 4 weeks, and 3 months postdonation. Predonation HRQOL markers were the strongest predictors of time to recovery. Poorer predonation physical health was associated with longer recovery (P = .017) and certain side effects in PBSC donors. Poorer predonation mental health was associated with longer recovery in BM donors (P = .03) and pain after PBSC donation (P = .003). Physical HRQOL scores declined significantly from predonation to 4 weeks postdonation. This was shown both for PBSC and BM donors (P < .001 and P = .009, respectively), but the decline was much greater for BM donors. There was a return to predonation HRQOL values 3 months after donation in both groups with values well above the mean of the general population (P < .001).

Recovery of Unrelated Donors of Peripheral Blood Stem Cells versus Recovery of Unrelated Donors of Bone Marrow: A Prespecified Analysis from the Phase III Blood and Marrow Transplant Clinical Trials Network Protocol 0201

“…International donors of both PBSC and BM recovered more quickly than did domestic donors. Likewise, in a recent analysis of 275 PBSC and 37 BM consecutive Anthony Nolan Registry donors, the median time to recovery was quite short for both products, being only 3 days for PBSC and 10 days for BM donors [20]. However, it is important to note that our study was limited by both the smaller proportion of international donors and that only two international donor centers participated, restricting the generalizability of our findings.…”

“…Donors in more recent years of the study recovered more quickly – whether this reflects donor centers’ increasing technical expertise, experience with care of donors participating on the trial or differences in general supportive care over time is not known. Predonation health-related quality of life scores were the strongest predictors of time to recovery in stem cell donors of unrelated donors of PBSC or BM from the United Kingdom [20]. Although a prespecified subgroup analysis of BMT CTN 0201 examined the physical and psychosocial experiences of 335 of the PBSC and BM donors (Department of Defense, German Registry and non-English speaking donors were excluded), the impact of predonation quality of life scores on time to recovery was not an objective of that analysis [21].…”

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

“…59 Another study included 275 PBSC and 37 BM consecutive donors who completed the SF-36 questionnaire predonation and 4 weeks, and 3 months post donation. 60 Predonation HRQoL markers were the strongest predictors of time to recovery. Poorer predonation physical health was associated with longer recovery (P = 0.017) and certain side effects in PBSC donors.…”

Targeted recruitment of male donors for allogeneic haematopoietic cell transplantation: A review of the evidence

“… highlight that female bone marrow and PBSC donors are associated with a higher risk of donation‐related toxicities and adverse reactions. Women donating PBSCs are more likely to experience pain, fatigue, nausea, vomiting and side‐effects of hypocalcaemia . Similarly, female bone marrow donors are more likely to experience toxicities including pain and fatigue and are less likely to experience complete recovery .…”

“…With both procedures, women were more likely to require extended hospitalization following donation , experience greater physical difficulty with donation and develop more serious complications . Female PBSC donors were also more likely than males to require a central line, a more invasive procedure itself associated with risks including bleeding, infection and pneumothorax . It is important to note that data related to adverse events are regulated and therefore captured systematically only for unrelated donors.…”