Recombinant human erythropoietin (rh-Epo) administration to normal child bone marrow donors

Summary:We evaluated the use of a semi-automated processing technique to salvage red blood cells from pediatric bone marrow donors to minimize the risk of severe anemia following bone marrow harvest and ABO incompatibility in the recipient. Sixty healthy, HLA-matched, pediatric donors of bone marrow hematopoietic cells with a median age 8.0 years (2-19) were studied. Thirteen of the donor-recipient pairs were ABO incompatible. There were 60 recipients with a median age of 8.

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Red cell salvage and reinfusion in pediatric bone marrow donors

Kletzel

Olszewski

Danner-Koptik

et al. 1999

“…To avoid the allogeneic blood transfusions that most young children and infant donors require, 2,3 some groups administer recombinant human EPO. 4 Other groups recommend using G-CSF-primed BM to get a higher BM cell yield, which is expected to lead to more rapid engraftment. 5,6 Our trial demonstrated the feasibility of bone marrow harvesting from pediatric donors without allotransfusion or mobilizing factors, perhaps making them the best control group for evaluating subsequent effects in healthy donors.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of marrow harvesting from pediatric sibling donors without hematopoietic growth factors and allotransfusion

Yabe

Morimoto

Shimizu

et al. 2014

We retrospectively studied 108 marrow harvests from 105 pediatric sibling donors. The median age of donors was 8 years (range: 1-15) and the median body weight was 27 kg (range: 10-100). The volumes of aspirated marrow were 5.0-23.8 mL/kg donor body weight, and harvested bone marrow volume exceeded 15 mL/kg in 42% of the donors. A total of 100 autologous blood donations were performed, and eight donors had red cells salvaged from their harvests reinfused. The median Hb levels before and after harvests were 12.3 g/dL (range: 10.0-14.7) and 11.0 g/dL (range: 8.9-13.8), respectively. None of the donors received allogeneic blood transfusions or hematopoietic growth factors such as EPO and G-CSF before or after collection. Transplanted dose was 1.4-10.8 × 10 8 cells/kg recipient body weight without differences due to donor age. Higher concentrations of nucleated and CD34 + cells were obtained from younger donors. All donors tolerated the procedures well, with no serious complications. Thus, children may safely donate marrow for allogeneic transplantation, and the yields of nucleated cells for engraftment are substantial.Bone Marrow Transplantation (2014) 49, 921-926;

“…Martinez et al 25 described the administration of recombinant EPO and iron to 11 donors before harvesting to avoid blood transfusion; this approach was successful but the use outside clinical protocols is not a standard procedure and exposes the donors to cytokines, which may have long-term effects. Moreover, in our clinical setting, the donors receiving allogeneic transfusions were all b-thalassemia carriers with erythroid hyperplasia and ineffective erythropoiesis, and therefore might benefit only marginally from rh-EPO administration.…”

Section: Discussionmentioning

confidence: 99%

Multiple BM harvests in pediatric donors for thalassemic siblings: safety, efficacy and ethical issues

Biral¹,

Chiesa²,

Cappelli³

et al. 2008

Allogeneic BMT represents the only chance of cure for b-thalassemia. Occasionally, two affected individuals from the same family share a matched healthy sibling. Moreover, a high incidence of transplant rejection is still observed in Pesaro class III patients, requiring a second BMT procedure. In these settings, one option is to perform a second BM harvest from the same donor. Although BM harvest is a safe procedure in children, ethical issues concerning this invasive practice still arise. Here, we describe our series of seven pediatric, healthy donors, who donated BM more than once in favor of their b-thalassemic HLA-identical siblings between June 2005 and January 2008. Three donors donated BM twice to two affected siblings and four donors donated twice for the same sibling following graft rejection of the first BMT. All donors tolerated the procedures well and no relevant side effects occurred. There was no significant difference between the two harvests concerning cell yield and time to engraftment. Our experience shows that for pediatric donors, a second BM donation is safe and feasible and good cellularity can be obtained. We suggest that a second harvest of a pediatric donor can be performed when a strong indication for BMT exists.