title: Analysis of the Effect of Race, Socioeconomic Status, and Center Size on Unrelated National Marrow Donor Program Donor Outcomes: Donor Toxicities Are More Common at Low-Volume Bone Marrow Collection Centers.
abstract: Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index, and age in unrelated donors undergoing collection at National Marrow Donor Program centers. We hypothesized that other important factors (race, socioeconomic status [SES], and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2726 bone marrow (BM) and 6768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week after donation (P = .017). For BM donors, black males reported significantly higher levels of pain (OR, 1.90; CI, 1.14 to 3.19; P = .015). No differences were noted by SES group. BM donors from low-volume centers reported more toxicity (OR, 2.09; CI, 1.26 to 3.46; P = .006). In conclusion, race and SES have a minimal effect on donation-associated symptoms. However, donors from centers performing ≤ 1 BM collection every 2 months have more symptoms after BM donation. Approaches should be developed by registries and low-volume centers to address this issue.
authors.affiliation: CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI. Electronic address: bshaw@doctors.org.uk.
authors.forename: Bronwen E
authors.initials: BE
authors.lastname: Shaw
authors.affiliation: CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI; CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN.
authors.forename: Brent R
authors.initials: BR
authors.lastname: Logan
authors.affiliation: CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN.
authors.forename: Deidre M
authors.initials: DM
authors.lastname: Kiefer
authors.affiliation: CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN.
authors.forename: Pintip
authors.initials: P
authors.lastname: Chitphakdithai
authors.affiliation: Allina Health, Minneapolis, MN.
authors.forename: Tanya L
authors.initials: TL
authors.lastname: Pedersen
authors.affiliation: Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA.
authors.forename: Hisham
authors.initials: H
authors.lastname: Abdel-Azim
authors.affiliation: Division of BMT, Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI.
authors.forename: Muneer H
authors.initials: MH
authors.lastname: Abidi
authors.affiliation: Stem Cell Transplantation and Cellular Therapy Program, Banner MD Anderson Cancer Center, Gilbert, AZ.
authors.forename: Gorgun
authors.initials: G
authors.lastname: Akpek
authors.affiliation: Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Diaz
authors.affiliation: Section of Hematology/Oncology, University of Chicago, Chicago, IL.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Artz
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Christopher
authors.initials: C
authors.lastname: Dandoy
authors.affiliation: Oregon Health and Science University, Portland, OR.
authors.forename: James L
authors.initials: JL
authors.lastname: Gajewski
authors.affiliation: Division of Hematology/Oncology/Bone Marrow Transplantation, University of Wisconsin Hospital and Clinics, Madison, WI.
authors.forename: Peiman
authors.initials: P
authors.lastname: Hematti
authors.affiliation: Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine Center for Cell and Gene Therapy, Houston, TX.
authors.forename: Rammurti T
authors.initials: RT
authors.lastname: Kamble
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC.
authors.forename: Kimberley A
authors.initials: KA
authors.lastname: Kasow
authors.affiliation: Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.affiliation: Department of Medicine, University of Rochester Medical Center, Rochester, NY.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Liesveld
authors.affiliation: Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.
authors.forename: Navneet S
authors.initials: NS
authors.lastname: Majhail
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Paul V
authors.initials: PV
authors.lastname: O'Donnell
authors.affiliation: Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Olsson
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Bipin N
authors.initials: BN
authors.lastname: Savani
authors.affiliation: Mayo Clinic Rochester, Rochester, MN.
authors.forename: Raquel M
authors.initials: RM
authors.lastname: Schears
authors.affiliation: Department of Transfusion Medicine, Clinical Center-NIH, Bethesda, MD.
authors.forename: David F
authors.initials: DF
authors.lastname: Stroncek
authors.affiliation: University of Pittsburgh, Pittsburgh, PA.
authors.forename: Galen E
authors.initials: GE
authors.lastname: Switzer
authors.affiliation: BeTheMatch/National Marrow Donor Program, Minneapolis, MN.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Williams
authors.affiliation: Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, FL.
authors.forename: John R
authors.initials: JR
authors.lastname: Wingard
authors.affiliation: Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA.
authors.forename: Baldeep M
authors.initials: BM
authors.lastname: Wirk
authors.affiliation: BeTheMatch/National Marrow Donor Program, Minneapolis, MN.
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Confer
authors.affiliation: Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital of Los Angeles, USC Keck School of Medicine, Los Angeles, CA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
mesh_terms: D000293:Adolescent; D000328:Adult; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D001772:Blood Cell Count; D015992:Body Mass Index; D016026:Bone Marrow Transplantation; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D005260:Female; D000069585:Filgrastim / Q000009:adverse effects; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data*; D061846:Hospitals, Low-Volume / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D036102:Peripheral Blood Stem Cell Transplantation; D044469:Racial Groups; D012923:Social Class; D014019:Tissue Donors / Q000706:statistics & numerical data; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000069585:Filgrastim
keywords: Bone marrow; Donor center; Donor toxicities; PBSC; Race; Socioeconomic status; Unrelated donor