title: Acute toxicities of unrelated bone marrow versus peripheral blood stem cell donation: results of a prospective trial from the National Marrow Donor Program.
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.
authors.affiliation: Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City, UT 84132, USA. michael.pulsipher@hsc.utah.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
authors.forename: Pintip
authors.initials: P
authors.lastname: Chitphakdithai
authors.forename: Brent R
authors.initials: BR
authors.lastname: Logan
authors.forename: Bronwen E
authors.initials: BE
authors.lastname: Shaw
authors.forename: John R
authors.initials: JR
authors.lastname: Wingard
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Waller
authors.forename: Matthew
authors.initials: M
authors.lastname: Seftel
authors.forename: David F
authors.initials: DF
authors.lastname: Stroncek
authors.forename: Angela M
authors.initials: AM
authors.lastname: Lopez
authors.forename: Dipnarine
authors.initials: D
authors.lastname: Maharaj
authors.forename: Peiman
authors.initials: P
authors.lastname: Hematti
authors.forename: Paul V
authors.initials: PV
authors.lastname: O'Donnell
authors.forename: Alison W
authors.initials: AW
authors.lastname: Loren
authors.forename: Susan F
authors.initials: SF
authors.lastname: Leitman
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.forename: Steven C
authors.initials: SC
authors.lastname: Goldstein
authors.forename: John E
authors.initials: JE
authors.lastname: Levine
authors.forename: Willis H
authors.initials: WH
authors.lastname: Navarro
authors.forename: John P
authors.initials: JP
authors.lastname: Miller
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Confer
mesh_terms: D000293:Adolescent; D000328:Adult; D000758:Anesthesia / Q000009:adverse effects; D001772:Blood Cell Count; D001781:Blood Component Removal / Q000009:adverse effects*; D001782:Blood Donors; D016026:Bone Marrow Transplantation; D003289:Convalescence; D005076:Exanthema / Q000453:epidemiology / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology*; D000069585:Filgrastim; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects* / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects* / Q000379:methods; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D036102:Peripheral Blood Stem Cell Transplantation; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000494:pharmacology; D013575:Syncope / Q000453:epidemiology / Q000209:etiology; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods; D014481:United States; D055815:Young Adult
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim