Effect of aging and predonation comorbidities on the related peripheral blood stem cell donor experience: Report from the Related Donor Safety Study Journal Article

Authors: Pulsipher, M. A.; Logan, B. R.; Chitphakdithai, P.; Kiefer, D. M.; Riches, M. L.; Rizzo, J. D.; Anderlini, P.; Leitman, S. F.; Varni, J. W.; Kobusingye, H.; Besser, R. M.; Miller, J. P.; Drexler, R. J.; Abdel-Mageed, A.; Ahmed, I. A.; Akard, L. P.; Artz, A. S.; Ball, E. D.; Bayer, R. L.; Bigelow, C.; Bolwell, B. J.; Broun, E. R.; Bunin, N. J.; Delgado, D. C.; Duckworth, K.; Dvorak, C. C.; Hahn, T. E.; Haight, A. E.; Hari, P. N.; Hayes-Lattin, B. M.; Jacobsohn, D. A.; Jakubowski, A. A.; Kasow, K. A.; Lazarus, H. M.; Liesveld, J. L.; Linenberger, M.; Litzow, M. R.; Longo, W.; Magalhaes-Silverman, M.; McCarty, J. M.; McGuirk, J. P.; Mori, S.; Prasad, V. K.; Rowley, S. D.; Rybka, W. B.; Sahdev, I.; Schriber, J. R.; Selby, G. B.; Shaughnessy, P. J.; Shenoy, S.; Spitzer, T.; Tse, W. T.; Uberti, J. P.; Vusirikala, M.; Waller, E. K.; Weisdorf, D. J.; Yanik, G. A.; Navarro, W. H.; Horowitz, M. M.; Switzer, G. E.; Shaw, B. E.; Confer, D. L.
Article Title: Effect of aging and predonation comorbidities on the related peripheral blood stem cell donor experience: Report from the Related Donor Safety Study
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 6 /L; age 41 to 60, 81 × 10 6 /L; age 18 to 40, 121 × 10 6 /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 9 /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. © 2018 American Society for Blood and Marrow Transplantation
Keywords: adult; controlled study; aged; middle aged; human cell; major clinical study; fatigue; hypertension; anorexia; cd34 antigen; controlled clinical trial; nausea; thrombocytopenia; vomiting; stem cell transplantation; age; dizziness; fever; injection site reaction; insomnia; symptom; peripheral blood stem cell; patient safety; comorbidity; stem cell mobilization; aging; headache; leukocyte count; high risk population; peripheral blood stem cell transplantation; pain assessment; granulocyte colony stimulating factor; plerixafor; patient counseling; platelet count; unrelated donor; apheresis; musculoskeletal pain; faintness; human; male; female; article; related donor; bm collection toxicities; donor safety; pbsc collection toxicities
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 25
Issue: 4
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2019-04-01
Start Page: 699
End Page: 711
Language: English
DOI: 10.1016/j.bbmt.2018.11.004
PUBMED: 30423480
PROVIDER: scopus
PMCID: PMC6453753
Notes: Source: Scopus
Altmetric Score
MSK Authors