期刊
HAEMATOLOGICA
卷 104, 期 4, 页码 844-854出版社
FERRATA STORTI FOUNDATION
DOI: 10.3324/haematol.2018.200121
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类别
资金
- NHLBI [R01 HL085707, 1U24HL138660]
- NHLBI/NCI [2UG1HL069254]
- Johnny Crisstopher Children's Charitable Foundation St. Baldrick's Consortium Grant
- National Cancer Institute (NCI) [5U24CA076518]
- National Heart, Lung and Blood Institute (NHLBI)
- National Institute of Allergy and Infectious Diseases (NIAID)
- NCI [1U24HL138660]
- Health Resources and Services Administration (HRSA/DHHS) [HHSH250201700006C]
- Office of Naval Research [N00014-17-1-2388, N00014-17-1-2850, N00014-18-1-2045]
- Adaptive Biotechnologies
- Amgen, Inc.
- Astellas Pharma US
- Atara Biotherapeutics, Inc.
- Be the Match Foundation
- bluebird bio, Inc.
- Bristol Myers Squibb Oncology
- Celgene Corporation
- Chimerix, Inc.
- CytoSen Therapeutics, Inc.
- Fred Hutchinson Cancer Research Center
- Gamida Cell Ltd.
- Gilead Sciences, Inc.
- HistoGenetics, Inc.
- Immucor
- Incyte Corporation
- Janssen Scientific Affairs, LLC
- Jazz Pharmaceuticals, Inc.
- Karius, Inc.
- Karyopharm Therapeutics, Inc.
- Kite Pharma, Inc.
- Medac, GmbH
- Mediware
- Medical College of Wisconsin
- Merck Co, Inc.
- Mesoblast
- MesoScale Diagnostics, Inc.
- Millennium, the Takeda Oncology Co.
- Miltenyi Biotec, Inc.
- Mundipharma EDO
- National Marrow Donor Program
- Novartis Pharmaceuticals Corporation
- PCORI
- Pfizer, Inc
- Pharmacyclics, LLC
- PIRCHE AG
- Sanofi Genzyme
- Seattle Genetics
- Shire
- Spectrum Pharmaceuticals, Inc.
- St. Baldrick's Foundation
- Swedish Orphan Biovitrum, Inc.
- Takeda Oncology
- University of Minnesota
Unlike unrelated donor registries, transplant centers lack uniform approaches to related donor assessment and deferral. To test whether related donors are at increased risk for donation-related toxicities, we conducted a prospective observational trial of 11,942 related and unrelated donors aged 18-60 years. Bone marrow (BM) was collected at 37 transplant and 78 National Marrow Donor Program centers, and peripheral blood stem cells (PBSC) were collected at 42 transplant and 87 unrelated donor centers in North America. Possible presence of medical comorbidities was verified prior to donation, and standardized pain and toxicity measures were assessed pre-donation, peri-donation, and one year following. Multivariate analyses showed similar experiences for BM collection in related and unrelated donors; however, related stem cell donors had increased risk of moderate [odds ratios (ORs) 1.42; P<0.001] and severe (OR 8.91; P<0.001) pain and toxicities (OR 1.84; P<0.001) with collection. Related stem cell donors were at increased risk of persistent toxicities (OR 1.56; P=0.021) and non-recovery from pain (OR 1.42; P=0.001) at one year. Related donors with more significant comorbidities were at especially high risk for grade 2-4 pain (OR 3.43; P<0.001) and non-recovery from toxicities (OR 3.71; P<0.001) at one year. Related donors with more significant comorbidities were at especially high risk for grade 2-4 pain (OR 3.43; P<0.001) and non-recovery from toxicities (OR 3.71; P<0.001) at one year. Related donors reporting grade >= 2 pain had significant decreases in Health-Related Quality of Life (HR-QoL) scores at one month and one year post donation (P=0.004). In conclusion, related PBSC donors with comorbidities are at increased risk for pain, toxicity, and non-recovery at one year after donation. Risk profiles described in this study should be used for donor education, planning studies to improve the related donor experience, and decisions regarding donor deferral.
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