Lower risk for serious adverse events and no increased risk for cancer after PBSC vs BM donation

• Published in: Blood 2014-06, Vol.123 (23), p.3655-3663
• Main Authors: Pulsipher, Michael A., Chitphakdithai, Pintip, Logan, Brent R., Navarro, Willis H., Levine, John E., Miller, John P., Shaw, Bronwen E., O’Donnell, Paul V., Majhail, Navneet S., Confer, Dennis L.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Bone Marrow; Bone Marrow Transplantation; Female; Granulocyte Colony-Stimulating Factor - adverse effects; Hematopoietic Stem Cell Mobilization - adverse effects; Hematopoietic Stem Cells; Humans; Male; Middle Aged; Neoplasms - epidemiology; Neoplasms - etiology; Peripheral Blood Stem Cell Transplantation; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Risk Factors; Severity of Illness Index; Tissue and Organ Harvesting - adverse effects; Tissue and Organ Harvesting - statistics & numerical data; Tissue Donors - statistics & numerical data; Transfusion Medicine; Young Adult
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2013-12-542464

We compared serious early and late events experienced by 2726 bone marrow (BM) and 6768 peripheral blood stem cell (PBSC) donors who underwent collection of PBSC or BM between 2004 and 2009 as part of a prospective study through the National Marrow Donor Program. Standardized FDA definitions for serious adverse events (SAEs) were used, and all events were reviewed by an independent physician panel. BM donors had an increased risk for SAEs (2.38% for BM vs 0.56% for PBSC; odds ratio [OR], 4.13; P < .001), and women were twice as likely to experience an SAE (OR for men, 0.50; P = .005). Restricting the analysis to life-threatening, unexpected, or chronic/disabling events, BM donors maintained an increased risk for SAEs (0.99% for BM vs 0.31% for PBSC; OR, 3.20; P < .001). Notably, the incidence of cancer, autoimmune illness, and thrombosis after donation was similar in BM vs PBSC donors. In addition, cancer incidence in PBSC donors was less than that reported in the general population (Surveillance, Epidemiology, and End Results Program database). In conclusion, SAEs after donation are rare but more often occurred in BM donors and women. In addition, there was no evidence of increased risk for cancer, autoimmune illness, and stroke in donors receiving granulocyte colony-stimulating factor during this period of observation. •BM donors have a threefold higher risk for life-threatening, serious unexpected, or chronic adverse events vs PBSC donors (0.99% vs 0.31%).•Donors receiving granulocyte colony-stimulating factor for PBSC collection had no evidence of increased risk for cancer, autoimmune illness, and stroke.