Donors' health state the year after peripheral haematopoietic progenitor cell collection: A prospective follow-up study in related and unrelated donors compared to first-time platelet donors

Pain is what hurts: An exploration of perception and management of pain in peripheral blood stem cell donors

BACKGROUND

Pain is a side effect of Granulocyte-Colony Stimulating Factor (G-CSF) administration. This prospective study investigates various aspects including pain perception occurring in Peripheral Blood Stem Cell (PBSC) donors.

MATERIALS AND METHODS

Related and unrelated PBSC donors were prospectively studied. Donors recorded pain symptoms during the four-day period of G-CSF administration using the McGill Pain Questionnaire, a Visual Analog Scale and a pain diary.

RESULTS

There were 208 donors included, 102 (49%) related and 106 (51%) unrelated donors. Ninety-two percent of all reported the occurrence of pain. Moderate or severe pain was reported by 52%. No differences were found between related and unrelated donors. Pain occurred more often in females (p = 0.035). Relatively young donors (age 16-30 years) more frequently showed to have pain in comparison to older donors (>50 years) (p = 0.006). Musculoskeletal pain was most frequently distributed in the gluteal and lower back region (65-71%). Irrespective of the pain location, pain was most often described as nagging, annoying, however tolerable. Donors experiencing pain most on days of G-CSF administration, most frequently occurring during relaxation or at night. Sleep-mode was often affected. The use of paracetamol (acetaminophen) was sufficient for all but one donor.

CONCLUSION

This is the first study to describe different aspects of pain associated with G-CSF administration in donors. Although the observed pain was tolerable, it should never be neglected. Knowledge derived from this study is of use for staff members involved in donor information and care management.

Long-term follow-up of cancer and catastrophic diseases in hematopoietic stem cell donors: a comprehensive matched cohort study

Hematopoietic stem cell (HSC) transplantation, using either bone marrow (BM) or peripheral blood stem cells (PBSC), is a well-established therapy for various hematologic and non-hematologic diseases. However, the long-term health outcomes after HSC donation remain a major concern for several potential donors. Thus, we aimed to conduct a matched cohort study of 5003 unrelated donors (1099 BM and 3904 PBSC) and randomly selected 50,030 matched controls based on age, sex, and resident area from the donor registry between 1998 and 2018. The medical insurance claims of all the participants were retrieved from the Taiwan National Health and Welfare Data Science Center after de-identification. Our findings revealed no differences in the incidence of cancer, death, and catastrophic diseases between HSC donors and matched healthy participants during long-term follow-up. Kaplan-Meier curves depicting the cumulative incidence of cancer and overall mortality throughout the follow-up period also demonstrated similar outcomes between donors and non-donors. In conclusion, our results indicate that HSC donation, whether through BM or PBSC, is safe and not associated with an increased risk of cancer, death, or catastrophic diseases. These findings provide valuable information for counseling potential HSC donors and for long-term management of HSC donor health.

Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience: Report from the Related Donor Safety Study

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 × 106/L; age 41 to 60, 81 × 106/L; age 18 to 40, 121 × 106/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 × 109/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.