Journal article
Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience: Report from the Related Donor Safety Study
Biology of blood and marrow transplantation, Vol.25(4), pp.699-711
04/2019
DOI: 10.1016/j.bbmt.2018.11.004
PMCID: PMC6453753
PMID: 30423480
Abstract
The development of reduced-intensity approaches for allogeneic hematopoietic cell transplantation has resulted in growing numbers of older related donors (RDs) of peripheral blood stem cells (PBSCs). The effects of age on donation efficacy, toxicity, and long-term recovery in RDs are poorly understood. To address this we analyzed hematologic variables, pain, donation-related symptoms, and recovery in 1211 PBSC RDs aged 18 to 79 enrolled in the Related Donor Safety Study. RDs aged > 60 had a lower median CD34
level before apheresis compared with younger RDs (age > 60, 59 × 10
/L; age 41 to 60, 81 × 10
/L; age 18 to 40, 121 × 10
/L; P < .001). This resulted in older donors undergoing more apheresis procedures (49% versus 30% ≥ 2 collections, P < .001) and higher collection volumes (52% versus 32% > 24 L, P < .001), leading to high percentages of donors aged > 60 with postcollection thrombocytopenia <50 × 10
/L (26% and 57% after 2 and 3days of collection, respectively). RDs aged 18 to 40 had a higher risk of grades 2 to 4 pain and symptoms pericollection, but donors over age 40 had more persistent pain at 1, 6, and 12 months (odds ratio [OR], 1.7; P = 0.02) and a higher rate of nonrecovery to predonation levels (OR, 1.7; P = .01). Donors reporting comorbidities increased significantly with age, and those with comorbidities that would have led to deferral by National Marrow Donor Program unrelated donor standards had an increased risk for persistent grades 2 to 4 pain (OR, 2.41; P < .001) and failure to recover to predonation baseline for other symptoms (OR, 2.34; P = .004). This information should be used in counseling RDs regarding risk and can assist in developing practice approaches aimed at improving the RD experience for high-risk individuals.
Details
- Title: Subtitle
- Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience: Report from the Related Donor Safety Study
- Creators
- Michael A Pulsipher - University of Southern CaliforniaBrent R Logan - Medical College of WisconsinPintip Chitphakdithai - Center for International Blood and Marrow Transplant ResearchDeidre M Kiefer - Center for International Blood and Marrow Transplant ResearchMarcie L Riches - University of North Carolina at Chapel HillJ Douglas Rizzo - Medical College of WisconsinPaolo Anderlini - The University of Texas MD Anderson Cancer CenterSusan F Leitman - National Institutes of HealthJames W Varni - Texas A&M UniversityHati Kobusingye - Center for International Blood and Marrow Transplant ResearchRaeAnne M Besser - Center for International Blood and Marrow Transplant Research, Minneapolis, MinnesotaJohn P Miller - National Marrow Donor ProgramRebecca J Drexler - Center for International Blood and Marrow Transplant ResearchAly Abdel-Mageed - Corewell Health Blodgett HospitalIbrahim A Ahmed - Children's Mercy HospitalLuke P Akard - Indiana Blood and Marrow Transplantation, Indianapolis, IndianaAndrew S Artz - University of ChicagoEdward D Ball - University of California San DiegoRuthee-Lu Bayer - Northwell HealthCarolyn Bigelow - University of MississippiBrian J Bolwell - Cleveland ClinicE Randolph Broun - Jewish HospitalNancy J Bunin - University of PennsylvaniaDavid C Delgado - Riley Hospital for ChildrenKatharine Duckworth - Wake Forest UniversityChristopher C Dvorak - University of California, San FranciscoTheresa E Hahn - Roswell Park Cancer InstituteAnn E Haight - Emory UniversityParameswaran N Hari - Medical College of WisconsinBrandon M Hayes-Lattin - Oregon Health & Science UniversityDavid A Jacobsohn - Children's NationalAnn A Jakubowski - Memorial Sloan Kettering Cancer CenterKimberly A Kasow - University of North Carolina at Chapel HillHillard M Lazarus - Case Western Reserve UniversityJane L Liesveld - University of RochesterMichael Linenberger - Fred Hutch Cancer CenterMark R Litzow - Mayo ClinicWalter Longo - UW Health University HospitalMargarida Magalhaes-Silverman - University of IowaJohn M McCarty - Virginia Commonwealth UniversityJoseph P McGuirk - University of KansasShahram Mori - Florida Hospital Cancer Institute, Florida Center for Cellular Therapy, Orlando, FloridaVinod K Prasad - Duke UniversityScott D Rowley - Hackensack University Medical CenterWitold B Rybka - Penn State Milton S. Hershey Medical CenterIndira Sahdev - Cohen Children's Medical CenterJeffrey R Schriber - Cancer Transplant Institute Honor Health, Scottsdale, ArizonaGeorge B Selby - University of OklahomaPaul J Shaughnessy - Texas Transplant Institute, San Antonio, TexasShalini Shenoy - Washington University in St. LouisThomas Spitzer - Harvard UniversityWilliam T Tse - Lurie Children's HospitalJoseph P Uberti - Wayne State UniversityMadhuri Vusirikala - The University of Texas Southwestern Medical CenterEdmund K Waller - Emory UniversityDaniel J Weisdorf - University of MinnesotaGregory A Yanik - University of MichiganWillis H Navarro - Center for International Blood and Marrow Transplant ResearchMary M Horowitz - Medical College of WisconsinGalen E Switzer - University of PittsburghBronwen E Shaw - Medical College of WisconsinDennis L Confer - Center for International Blood and Marrow Transplant Research
- Resource Type
- Journal article
- Publication Details
- Biology of blood and marrow transplantation, Vol.25(4), pp.699-711
- DOI
- 10.1016/j.bbmt.2018.11.004
- PMID
- 30423480
- PMCID
- PMC6453753
- NLM abbreviation
- Biol Blood Marrow Transplant
- ISSN
- 1083-8791
- eISSN
- 1523-6536
- Grant note
- U24 HL138660 / NHLBI NIH HHS U24 CA076518 / NCI NIH HHS R01 HL085707 / NHLBI NIH HHS UG1 HL069254 / NHLBI NIH HHS
- Language
- English
- Date published
- 04/2019
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359944302771
Metrics
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