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Related peripheral blood stem cell donors experience more severe symptoms and less complete recovery at 1-year compared to unrelated donors. Haematologica 2018 Oct 31 PMID: 30381298

Pubmed ID

30381298

Abstract

Unlike unrelated donor registries, transplant centers lack uniform approaches to related donor assessment and deferral. To test whether related donors are at increased risk for donation related toxicities we conducted a prospective observational trial of 11,942 related and unrelated age 18-60. Bone marrow was collected at 37 transplant and 78 National Marrow Donor Program centers and peripheral blood stem cells were collected at 42 transplant and 87 unrelated donor centers in North America. Ascertainment of medical comorbidities occurred prior to donation and standardized pain and toxicity measures were assessed pre-donation, peri-donation, and one year following. Multivariate analyses showed similar experiences for marrow collection in related and unrelated donors, however, related stem cell donors had increased risk of moderate (OR 1.42, p<0.001) and severe pain (OR 8.91, p<0.001) and toxicities (OR 1.84, p<0.001) with collection. Related stem cell donors were at increased risk of persistent toxicities (OR 1.56 p=0.021) and non-recovery from pain (OR 1.42 p=0.001) at 1 year. RD with more significant comorbidities were at especially high risk for grade 2-4 pain (OR 3.43, p<0.001) and non-recovery from toxicities (OR 3.71, p<0.001) at 1 year. Related donors with more significant comorbidities were at especially high risk for grade 2-4 pain (OR 3.43, p<0.001) and non-recovery from toxicities (OR 3.71, p<0.001) at 1 year. Related donors reporting grade ≥2 pain had significant decreases in HR-QoL at 1 month and 1 year post-donation (p=0.004). Conclusion: related peripheral blood stem cell donors with comorbidities are at increased risk for pain, toxicity, and non-recovery at 1 year after donation. Risk profiles described in this study should be used for donor education, planning studies to improve the related donor experience, and decisions regarding donor deferral. Clinicaltrials.gov NCT00948636.

Author List

Pulsipher MA, Logan BR, Kiefer DM, Chitphakdithai P, Riches ML, Rizzo JD, Anderlini P, Leitman SF, Kobusingye H, Besser RM, Miller JP, Drexler RJ, Abdel-Mageed A, Ahmed IA, Akard LP, Artz AS, Ball ED, Bayer RL, Bigelow C, Bolwell BJ, Broun ER, Delgado DC, Duckworth K, Dvorak CC, Hahn TE, Haight AE, Hari PN, Hayes-Lattin BM, Jacobsohn DA, Jakubowski AA, Kasow KA, Lazarus HM, Liesveld JL, Linenberger M, Litzow MR, Longo W, Magalhaes-Silverman M, McCarty JM, McGuirk JP, Mori S, Parameswaran V, Prasad VK, Rowley SD, Rybka WB, Sahdev I, Schriber JR, Selby GB, Shaughnessy PJ, Shenoy S, Spitzer T, Tse WT, Uberti JP, Vusirikala M, Waller EK, Weisdorf DJ, Yanik GA, Navarro WH, Horowitz MM, Switzer GE, Confer DL, Shaw BE

Authors

Parameswaran Hari MD Chief, Professor in the Medicine department at Medical College of Wisconsin
Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
J. Douglas D. Rizzo MD, MS Director, Ctr Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Bronwen E. Shaw MBChB, PhD Professor in the Medicine department at Medical College of Wisconsin




jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6