Differences between graft product and donor side effects following bone marrow or stem cell donation.
We report graft product stem cell yields and donor safety results of a randomized multicenter study comparing allogeneic peripheral blood stem cell (PBSC) PBSC transplantation with BM transplantation. Matched HLA-identical sibling donors (n=329) were randomized to filgrastim-mobilized PBSC or bone marrow (BM) donation groups. Median yields per kg recipient weight of CD34(+) cells, T cells, and natural killer (NK) cells, respectively, were approximately two-fold, eight-fold, and greater than eight-fold in the PBSC group than in the BM group (CD34(+) cells, 5.8 x 10(6)/kg vs 2.7 x 10(6)/kg; T cells, 300.1 x 10(6)/kg vs 35.7 x 10(6)/kg; NK cells, 28.2 x 10(6)/kg vs 3.6 x 10(6)/kg; P<0.001 for each). In connection with the cell collection procedures, PBSC donors spent a shorter median time in hospital than BM donors (0 vs 2 days; median difference -2 days, 95% CI -2 to 2) and had fewer median days of restricted activity (2 vs 6 days; median difference -3 days, 95% CI -4 to 2). Overall, 65% of PBSC donors and 57% of BM donors reported at least one adverse event (AE), most of which were transient, mild-moderate in severity, and without clinical sequelae. PBSC donors experienced predominantly filgrastim-related AEs, while BM donors experienced predominantly harvest-related AEs.
Favre
G
G
Division of Hematology and Hematology Laboratory, Kantonsspital Basel, Basel, Switzerland. gfavre@uhbs.ch
Beksaç
M
M
Bacigalupo
A
A
Ruutu
T
T
Nagler
A
A
Gluckman
E
E
Russell
N
N
Apperley
J
J
Szer
J
J
Bradstock
K
K
Buzyn
A
A
Matcham
J
J
Gratwohl
A
A
Schmitz
N
N
D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34; D001781:Blood Component Removal / Q000009:adverse effects* / Q000592:standards*; D016026:Bone Marrow Transplantation / Q000379:methods / Q000592:standards*; D002452:Cell Count; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006801:Humans; D007694:Killer Cells, Natural; D007937:Leukapheresis; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods / Q000592:standards*; D011994:Recombinant Proteins; D035781:Siblings; D013601:T-Lymphocytes; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014185:Transplantation, Isogeneic
D018952:Antigens, CD34; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim