TY - JOUR
T1 - Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience
T2 - Report from the Related Donor Safety Study
AU - Pulsipher, Michael A.
AU - Logan, Brent R.
AU - Chitphakdithai, Pintip
AU - Kiefer, Deidre M.
AU - Riches, Marcie L.
AU - Rizzo, J. Douglas
AU - Anderlini, Paolo
AU - Leitman, Susan F.
AU - Varni, James W.
AU - Kobusingye, Hati
AU - Besser, Rae Anne M.
AU - Miller, John P.
AU - Drexler, Rebecca J.
AU - Abdel-Mageed, Aly
AU - Ahmed, Ibrahim A.
AU - Akard, Luke P.
AU - Artz, Andrew S.
AU - Ball, Edward D.
AU - Bayer, Ruthee Lu
AU - Bigelow, Carolyn
AU - Bolwell, Brian J.
AU - Broun, E. Randolph
AU - Bunin, Nancy J.
AU - Delgado, David C.
AU - Duckworth, Katharine
AU - Dvorak, Christopher C.
AU - Hahn, Theresa E.
AU - Haight, Ann E.
AU - Hari, Parameswaran N.
AU - Hayes-Lattin, Brandon M.
AU - Jacobsohn, David A.
AU - Jakubowski, Ann A.
AU - Kasow, Kimberly A.
AU - Lazarus, Hillard M.
AU - Liesveld, Jane L.
AU - Linenberger, Michael
AU - Litzow, Mark R.
AU - Longo, Walter
AU - Magalhaes-Silverman, Margarida
AU - McCarty, John M.
AU - McGuirk, Joseph P.
AU - Mori, Shahram
AU - Prasad, Vinod K.
AU - Rowley, Scott D.
AU - Rybka, Witold B.
AU - Sahdev, Indira
AU - Schriber, Jeffrey R.
AU - Selby, George B.
AU - Shaughnessy, Paul J.
AU - Shenoy, Shalini
AU - Spitzer, Thomas
AU - Tse, William T.
AU - Uberti, Joseph P.
AU - Vusirikala, Madhuri
AU - Waller, Edmund K.
AU - Weisdorf, Daniel J.
AU - Yanik, Gregory A.
AU - Navarro, Willis H.
AU - Horowitz, Mary M.
AU - Switzer, Galen E.
AU - Shaw, Bronwen E.
AU - Confer, Dennis L.
N1 - Publisher Copyright:
© 2018 American Society for Blood and Marrow Transplantation
PY - 2019/4
Y1 - 2019/4
N2 - 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.
AB - 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.
KW - BM collection toxicities
KW - Donor safety
KW - PBSC collection toxicities
KW - Stem cell transplantation
UR - http://www.scopus.com/inward/record.url?scp=85058455309&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2018.11.004
DO - 10.1016/j.bbmt.2018.11.004
M3 - Article
C2 - 30423480
AN - SCOPUS:85058455309
SN - 1083-8791
VL - 25
SP - 699
EP - 711
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 4
ER -