Shorter Interdonation Interval Contributes to Lower Cell Counts in Subsequent Stem Cell Donations
Year: 2021
Type: article
Study design: Observational Study
Abstract: Approximately 7% of unrelated hematopoietic stem cell donors are asked to donate stem cells a subsequent time to the same or a different recipient. Recent studies have shown that donation-related symptoms for second donations are similar to those for the first donation. Little is known about differences in stem cell mobilization and yields for subsequent peripheral blood stem cell (PBSC) and bone marrow (BM) collections. We hypothesized that CD34+ cell yields and total nucleated cell (TNC) concentrations for subsequent PBSC or BM donations are lower than those at the first donation. We also evaluated the factors influencing stem cell yields in healthy unrelated second-time donors. Data were gathered from the Center for International Blood and Marrow Transplant Research database on 513 PBSC and 43 BM donors who donated a second time between 2006 and 2017 through the National Marrow Donor Program. Among the second-time PBSC donors, we found significantly lower preapheresis peripheral blood CD34+ cell counts (68.6 × 106/L versus 73.9 × 106/L; P = .03), and collection yields (556 × 106 versus 608 × 106; P = .02) at the second donation compared to the first. This decrease at the subsequent donation was associated with a shorter interdonation interval, lower body mass index (BMI), and a lower total G-CSF dose. In most instances, suboptimal mobilizers at their first donation donated suboptimal numbers of stem cells at their subsequent donations. Among repeat BM donors, the TNC concentration was lower at the second donation. The small size of this group precluded additional analysis. Overall, when considering repeat donations, increasing the interdonation intervals and evaluating for BMI changes should be considered to optimize stem cell yields. Some of these parameters may be improved by increasing G-CSF dose in PBSC donors within permissible limits.
Institutions: National Institutes of Health, National Institutes of Health Clinical Center, Medical College of Wisconsin, National Marrow Donor Program, Vanderbilt University Medical Center, National Cancer Institute, Center for Cancer Research, University of Florida Health, University of Florida, UF Health Cancer Center, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, The University of Texas MD Anderson Cancer Center, University of Wisconsin–Madison, UW Health University Hospital, University of Southern California, Children's Hospital Los Angeles
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,650
Funders: U.S. Department of Defense, Amgen, Bristol-Myers Squibb, Astellas Pharma US, Stanford University, Celgene, HistoGenetics, Boston Children's Hospital, CSL Behring, Medical College of Wisconsin, Jazz Pharmaceuticals, Government of South Australia, Angiocrine Bioscience, Kiadis Pharma, Shire, National Institutes of Health, Health Resources and Services Administration, Johnson and Johnson, U.S. Public Health Service, U.S. Navy, Merck Sharp and Dohme, Biomedical Advanced Research and Development Authority, Sanofi Genzyme, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases, Janssen Biotech
Awards: Cost Effectiveness Analysis of Stem Cell Transplant in Older MDS Patients, Identifying Predictors of Poor Health-Related Quality-of-life among Pediatric Hematopoietic Stem Cell Donors, G1664930879, G3158753476, G345720138, G3699198379, G3922948135, G460283006, Cure Sickle Cell, G4910750673, G5186918478, G5356860631, G5735794559, G6079157135, G746619137, G772836402, G8039400965, G9000004271, G9000065886, G9000066622, G9000165770, G9000211999, G9000227658, G9000232687, G9000293757, Molecular and Cellular Mechanisms of Chronic Myelomonocytic Leukemia (CMML), Immuno and Epigenetics of Hematopoietic Cell Transplantation, A Data Resource for Blood and Marrow Transplants and Adoptive Cellular Therapy Research, Blood and Marrow Transplant Clinical Trials Network DCC- The Medical College of Wisconsin, Inc.
OpenAlex ID: W3135328401