Adverse events among 2408 unrelated donors of peripheral blood stem cells: results of a prospective trial from the National Marrow Donor Program.
Limited data are available describing donor adverse events (AEs) associated with filgrastim mobilized peripheral blood stem cell (PBSC) collections in unrelated volunteers. We report results in 2408 unrelated PBSC donors prospectively evaluated by the National Marrow Donor Program (NMDP) between 1999 and 2004. Female donors had higher rates of AEs, requiring central line placement more often (17% vs 4%, P< .001), experiencing more apheresis-related AEs (20% vs 7%, P< .001), more bone pain (odds ratio [OR]=1.49), and higher rates of grades II-IV and III-IV CALGB AEs (OR=2.22 and 2.32). Obese donors experienced more bone pain (obese vs normal, OR=1.73) and heavy donors had higher rates of CALGB toxicities (>95 kg vs <70 kg, OR=1.49). Six percent of donors experienced grade III-IV CALGB toxicities and 0.6% experienced toxicities that were considered serious and unexpected. Complete recovery is universal, however, and no late AEs attributable to donation have been identified. In conclusion, PBSC collection in unrelated donors is generally safe, but nearly all donors will experience bone pain, 1 in 4 will have significant headache, nausea, or citrate toxicity, and a small percentage will experience serious short-term adverse events. In addition, women and larger donors are at higher risk for donation-related AEs.
Pulsipher
Michael A
MA
University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, UT 84132-2408, USA. michael.pulsipher@hsc.utah.edu
Chitphakdithai
Pintip
P
Miller
John P
JP
Logan
Brent R
BR
King
Roberta J
RJ
Rizzo
J Douglas
JD
Leitman
Susan F
SF
Anderlini
Paolo
P
Haagenson
Michael D
MD
Kurian
Seira
S
Klein
John P
JP
Horowitz
Mary M
MM
Confer
Dennis L
DL
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001772:Blood Cell Count; D001781:Blood Component Removal / Q000009:adverse effects* / Q000706:statistics & numerical data; D001782:Blood Donors; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D000069585:Filgrastim; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects*; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects* / Q000706:statistics & numerical data; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology*; D011446:Prospective Studies; D011994:Recombinant Proteins; D012307:Risk Factors; D017678:Sex Distribution; D055815:Young Adult
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim