1. Acute toxicities of unrelated bone marrow versus peripheral blood stem cell donation: results of a prospective trial from the National Marrow Donor Program.
- Author
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Pulsipher MA, Chitphakdithai P, Logan BR, Shaw BE, Wingard JR, Lazarus HM, Waller EK, Seftel M, Stroncek DF, Lopez AM, Maharaj D, Hematti P, O'Donnell PV, Loren AW, Leitman SF, Anderlini P, Goldstein SC, Levine JE, Navarro WH, Miller JP, and Confer DL
- Subjects
- Adolescent, Adult, Anesthesia adverse effects, Blood Cell Count, Convalescence, Exanthema epidemiology, Exanthema etiology, Fatigue epidemiology, Female, Fever epidemiology, Filgrastim, Gastrointestinal Diseases epidemiology, Gastrointestinal Diseases etiology, Granulocyte Colony-Stimulating Factor pharmacology, Hematopoietic Stem Cell Mobilization methods, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Obesity epidemiology, Pain epidemiology, Prospective Studies, Recombinant Proteins adverse effects, Recombinant Proteins pharmacology, Syncope epidemiology, Syncope etiology, Tissue and Organ Harvesting methods, United States, Young Adult, Blood Component Removal adverse effects, Blood Donors, Bone Marrow Transplantation, Fatigue etiology, Fever etiology, Granulocyte Colony-Stimulating Factor adverse effects, Hematopoietic Stem Cell Mobilization adverse effects, Pain etiology, Peripheral Blood Stem Cell Transplantation, Tissue Donors, Tissue and Organ Harvesting adverse effects
- Abstract
Although peripheral blood stem cells (PBSCs) have replaced bone marrow (BM) as the most common unrelated donor progenitor cell product collected, a direct comparison of concurrent PBSC versus BM donation experiences has not been performed. We report a prospective study of 2726 BM and 6768 PBSC donors who underwent collection from 2004 to 2009. Pain and toxicities were assessed at baseline, during G-CSF administration, on the day of collection, within 48 hours of donation, and weekly until full recovery. Peak levels of pain and toxicities did not differ between the 2 donation processes for most donors. Among obese donors, PBSC donors were at increased risk of grade 2 to 4 pain as well as grade 2 to 4 toxicities during the pericollection period. In contrast, BM donors were more likely to experience grade 2 to 4 toxicities at 1 week and pain at 1 week and 1 month after the procedure. BM donors experienced slower recovery, with 3% still not fully recovered at 24 weeks, whereas 100% of PBSC donors had recovered. Other factors associated with toxicity included obesity, increasing age, and female sex. In summary, this study provides extensive detail regarding individualized risk patterns of PBSC versus BM donation toxicity, suggesting donor profiles that can be targeted with interventions to minimize toxicity.
- Published
- 2013
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