title: Eighteen years experience of granulocyte donations-acceptable donor safety?
abstract: BACKGROUND
  Granulocyte transfusions are given to patients with life-threatening infections, refractory to treatment. The donors are stimulated with corticosteroids ± granulocyte colony stimulating factor (G-CSF). However, data regarding the donors' safety is sparse. The objective was therefore to evaluate short- and long-term adverse events (AE) in G-CSF stimulated donors.
  
  
  METHODS
  All consecutive granulocyte donors from 1994 to 2012 were identified through our registry. From the donation records, the number of aphereses, stimulation therapy, AE, blood values post donation, and recent status were evaluated.
  
  
  RESULTS
  One hundred fifty-four volunteer donors were mobilized for 359 collections. Age at first granulocyte donation was 43 years (median; range 19-64 years). Follow-up was 60 months (median; range 0-229 months). The dose of G-CSF per collection was 3.8 ug/kg body weight (median; range 1.6-6.0 ug/kg). Sedimentation agent was HES. Short-term AE were mild. Blood values 4 weeks post donation with minor reductions/elevations mostly resolved in later donations. Fourteen donors were excluded from the registry due to hypertension (4), diabetes (2), atrial flutter (1), breast carcinoma (1), urethral carcinoma in situ (1), MGUS (1), thrombosis (1), anaphylaxis (1), primary biliary cirrhosis (1), and unknown (1). Three donors are deceased due to diabetes, acute myocardial infarction, and unknown cause. All excluded/deceased donors except one were excluded/died at least 6 months after first granulocyte donation.
  
  
  CONCLUSIONS
  No serious short-term AE were observed. Due to the variability of diagnoses among excluded/deceased donors, we propose that it is less likely that granulocyte donations have a causative impact on these donors' exclusion or death.
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.|Department of Haematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ulla
authors.initials: U
authors.lastname: Axdorph Nygell
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Agneta
authors.initials: A
authors.lastname: Sollén-Nilsson
authors.affiliation: Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Joachim
authors.initials: J
authors.lastname: Lundahl
mesh_terms: D000328:Adult; D001782:Blood Donors; D001800:Blood Specimen Collection / Q000009:adverse effects*; D002423:Cause of Death; D003907:Dexamethasone / Q000009:adverse effects / Q000494:pharmacology*; D046148:Donor Selection; D005221:Fatigue / Q000209:etiology; D005260:Female; D000069585:Filgrastim / Q000009:adverse effects / Q000494:pharmacology*; D005500:Follow-Up Studies; D006098:Granulocytes / Q000187:drug effects / Q000637:transplantation*; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000494:pharmacology*; D006895:Hydroxyethyl Starch Derivatives; D007937:Leukapheresis / Q000379:methods*; D017708:Leukocyte Transfusion; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology; D055815:Young Adult
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D003907:Dexamethasone; D000069585:Filgrastim; D006854:Hydrocortisone
keywords: donor; follow-up; granulocyte donation; safety