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Stem Cell Source

Donation of stem cells from blood or bone marrow: results of a randomised study of safety and complaints

Bone Marrow Transplantation volume 29, pages 479–486 (2002)Cite this article

Abstract

Biological consequences and physical complaints were compared for donors randomly assigned either to blood stem cell (BSC) or bone marrow (BM) donation. In the period 1994–1999, 61 consecutive donors were included. The BSC donors were given G-CSF 10 μg/kg s.c., daily during 5 days before the first leukapheresis. Nineteen donors had one leukapheresis, 10 required two and one donor needed three leukaphereses in order to reach the target cell number of 2 × 106 CD34+ cells/kg bw of the recipient. A median platelet nadir of 102 × 109/l was reached shortly after the last leukapheresis. Three weeks post harvest, 17 of 30 BSC donors had a mild leukopenia. Six had a leukopenia lasting more than a year before returning to normal values. Both groups were monitored prospectively through a standardised questionnaire completed by the donors. BSC donation was significantly less burdensome than BM donation and was preferred by the donors. The short-term risks of BSC mobilisation and harvest seem negligible. The potential long-term effects of G-CSF are unresolved and the donors must be followed closely.

Bone Marrow Transplantation (2002) 29, 479–486. doi:10.1038/sj.bmt.1703418

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References

  1. Bortin MM, Buckner CD . Major complications of marrow harvesting for transplantation Exp Hematol 1983 10: 916 921

    Google Scholar 

  2. Stroncek DF, Holland PV, Bartch G et al. Experiences of the first 493 unrelated marrow donors in the National Marrow Donor Program Blood 1993 7: 1940 1946

    Google Scholar 

  3. Buckner CD . Clift RA, Sanders JE et al. Marrow harvesting from normal donors Blood 1984 64: 630 634

    CAS  PubMed  Google Scholar 

  4. Stroncek DF, Confer DL, Leitman SF . Peripheral progenitor cells for HPC transplants involving unrelated donors Transfusion 2000 40: 731 741

    Article  CAS  PubMed  Google Scholar 

  5. Schmitz N, Bacigalupo A, Hasenclever D et al. Allogeneic bone marrow transplantation vs filgrastim-mobilised peripheral blood progenitor cell transplantation in patients with early leukaemia: first results of a randomised multicentre trial of European Group for Blood and Marrow Transplantation Bone Marrow Transplant 1998 21: 995 1003

    Article  CAS  PubMed  Google Scholar 

  6. Vigoreto AC, Azevedo WM, Marques JF et al. A randomised, prospective comparison of allogeneic bone marrow and peripheral blood progenitor cell transplantation in the treatment of haematological malignancies Bone Marrow Transplant 1998 22: 1145 1151

    Article  Google Scholar 

  7. Blaise D, Kuentz M, Fortanier C et al. Randomized trial of bone marrow versus lenogratim-primed blood cell allogeneic transplantation in patients with early-stage leukemia: a report from the Société Française de Greffe de Moelle J Clin Oncol 2000 18: 537 546

    Article  CAS  PubMed  Google Scholar 

  8. Powles R, Mehta J, Kulkarni S et al. Allogeneic blood and bone-marrow stem-cell transplantation in haematological malignant diseases: a randomised trial Lancet 2000 355: 1231 1237

    Article  CAS  PubMed  Google Scholar 

  9. Heldal D, Tjønnfjord G, Brinch L et al. A randomised study of allogeneic transplantation with stem cells from blood or bone marrow Bone Marrow Transplant 2000 25: 1129 1136

    Article  CAS  PubMed  Google Scholar 

  10. Champlin RE, Schmitz N, Horowitz MM et al. Blood stem cells compared with bone marrow as a source of hematopoietic cells for allogeneic transplantation Blood 2000 12: 3702 3709

    Google Scholar 

  11. Bensinger WI, Martin PJ, Storer B et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematological cancers New Engl J Med 2001 3: 175 181

    Article  Google Scholar 

  12. Bensinger WI, Price TH, Dale DC et al. The effects of daily recombinant human granulocyte colony-stimulating factor administration on normal granulocyte donors undergoing leukapheresis Blood 1993 7: 1883 1888

    Google Scholar 

  13. Russel JA, Luider J, Weaver M et al. Collection of progenitor cells for allogeneic transplantation from peripheral blood of normal donors Bone Marrow Transplant 1995 15: 111 115

    Google Scholar 

  14. Miflin G, Charley C, Stainer C et al. Stem cell mobilization in normal donors for allogeneic transplantation: analysis of safety and factors affecting efficacy Br J Haematol 1996 95: 345 348

    Article  CAS  PubMed  Google Scholar 

  15. Anderlini P, Przepiorka D, Seong D et al. Clinical toxicity and laboratory effects of granulocyte-colony-stimulating factor (filgrastim) mobilization and blood stem cell apheresis from normal donors, and analysis of charges for the procedures Transfusion 1996 36: 590 595

    Article  CAS  PubMed  Google Scholar 

  16. Majolino I, Cavallaro AM, Bacigalupo A et al. Mobilization and collection of PBSC in healthy donors: a retrospective analysis of the Italian Bone Marrow Transplantation Group (GITMO) Haematologica 1997 82: 47 52

    CAS  PubMed  Google Scholar 

  17. Anderlini P, Körbling M, Dale D et al. Allogeneic blood stem cell transplantation: consideration for donors Blood 1997 3: 903 908

    Google Scholar 

  18. Stroncek DF, Clay ME, Herr G et al. Blood counts in healthy donors 1 year after the collection of granulocyte-colony-stimulating factor-mobilized progenitor cells and the results of a second mobilization and collection Tranfusion 1997 37: 304 308

    Article  CAS  Google Scholar 

  19. Novotny J, Kadar J, Hertenstein B et al. Sustained decrease of peripheral lymphocytes after allogeneic blood stem cell aphereses Br J Haematol 1998 100: 695 697

    Article  CAS  PubMed  Google Scholar 

  20. Anderlini P, Przepiorka D, Körbling, Champlin R . Blood stem cell procurement: donor safety issues Bone Marrow Transplant 1998 21: (Suppl. 3) 35 39

    Google Scholar 

  21. Ordemann R, Holig K, Wagner K et al. Acceptance and feasibility of peripheral stem cell mobilisation compared to bone marrow collection from healthy unrelated donors Bone Marrow Transplant 1998 21: (Suppl. 3) 25 28

    Google Scholar 

  22. Korbling M . Collection of allogeneic peripheral blood stem cells Baillières Best Pract Res Clin Haematol 1999 1: 41 45

    Article  Google Scholar 

  23. Anderlini P, Donato M, Chan KW et al. Allogeneic blood progenitor cell collection in normal donors after mobilization with filgrastim: the MD Anderson Cancer Center experience Transfusion 1999 39: 555 560

    Article  CAS  PubMed  Google Scholar 

  24. De la Rubia J, Martinez C, Solano C et al. Administration of recombinant human granulocyte colony-stimulating factor to normal donors: results of the Spanish Group of Allo-PBT Bone Marrow Transplant 1999 24: 723 728

    Article  CAS  PubMed  Google Scholar 

  25. Murata M, Harada M, Kato S et al. Peripheral blood stem cell mobilization and apheresis: analysis of adverse events in 94 normal donors Bone Marrow Transplant 1999 24: 1065 1071

    Article  CAS  PubMed  Google Scholar 

  26. Stroncek DF, Clay ME, Jaszcz W et al. Collection of two peripheral blood stem cell concentrates from healthy donors Transfus Med 1999 9: 37 50

    Article  CAS  PubMed  Google Scholar 

  27. Becker PS, Wagle M, Matous S et al. Spontaneous splenic rupture following administration of granulocyte colony-stimulating factor (G-CSF): occurrence in an allogeneic donor of peripheral blood stem cells Biol Blood Marrow Transplant 1997 3: 45 49

    CAS  PubMed  Google Scholar 

  28. Kawachi Y, Watanabe A, Uchida T et al. Acute arterial thrombosis due to platelet aggregation in a patient receiving granulocyte colony-stimulating factor Br J Haematol 1996 94: 413 416

    Article  CAS  PubMed  Google Scholar 

  29. Parkkali T, Volin L, Sirén MK, Ruutu T . Acute iritis induced by granulocyte colony-stimulating factor used for mobilization in a volunteer unrelated peripheral blood progenitor cell donor Bone Marrow Transplant 1996 17: 433 434

    CAS  PubMed  Google Scholar 

  30. Cavallaro AM, Lilleby K, Majolino I et al. Three to six year follow up of normal donors who received recombinant human granulocyte colony-stimulating factor Bone Marrow Transplant 2000 25: 85 89

    Article  CAS  PubMed  Google Scholar 

  31. Majolino I, Saglio G, Scime R et al. High incidence of chronic GVHD after primary allogeneic peripheral blood stem cell transplantation in patients with hematologic malignancies Bone Marrow Transplant 1996 17: 555 560

    CAS  PubMed  Google Scholar 

  32. Miflin G, Russel NH, Hutchinson RM et al. Allogeneic peripheral stem cell transplantation for haematologic malignancies – an analysis of kinetics of engraftment and GVHD risk Bone Marrow Transplant 1997 19: 9 13

    Article  CAS  PubMed  Google Scholar 

  33. Storek J, Gooley T, Siadak M et al. Allogeneic peripheral blood stem cell transplantation may be associated with a higher risk of chronic graft-versus-host disease Blood 1997 90: 4705 4709

    CAS  PubMed  Google Scholar 

  34. Solano C, Martinez C, Brunet S et al. Chronic graft-versus-host disease after allogeneic peripheral blood progenitor cell or bone marrow transplantation from matched related donors: a case-control study Bone Marrow Transplant 1998 22: 1129 1135

    Article  CAS  PubMed  Google Scholar 

  35. Brown RA, Adkins D, Khoury H et al. Long-term follow-up of high-risk allogeneic peripheral-blood stem-cell transplant recipients: graft-versus-host disease and transplant-related mortality J Clin Oncol 1999 17: 806 812

    Article  CAS  PubMed  Google Scholar 

  36. Johnsen HE, Knudsen LM . Nordic flow cytometry standards for CD34+ cell enumeration in blood and leukapheresis products: report from the second Nordic Workshop. Nordic Stem Cell Laboratory Group (NSCL-G) J Hematother 1996 5: 237 245

    Article  CAS  PubMed  Google Scholar 

  37. Switzer GE, Goycoolea JM, Dew EC et al. Donating stimulated peripheral blood stem cells vs bone marrow: do donors experience the procedures differently? Bone Marrow Transplant 2001 27: 917 923

    Article  CAS  PubMed  Google Scholar 

  38. Rowley SD, Donaldson G, Lilleby K et al. Experiences of donors enrolled in a randomized study of allogeneic bone marrow or peripheral blood stem cell transplantation Blood 2001 97: 2541 2548

    Article  CAS  PubMed  Google Scholar 

  39. Neupogen. Amgen Thousand Oaks, California 1994 (package insert)

  40. LeBlanc R, Roy J, Demers C, Cantin G . A prospective study of G-CSF effects on hemostasis in allogeneic blood stem cell donors Bone Marrow Transplant 1999 23: 991 996

    Article  CAS  PubMed  Google Scholar 

  41. Falanga A, Marchetti M, Oldani E et al. Changes of hemostatic parameters in healthy donors administered G-CSF for peripheral blood progenitor cells (PBPC) collection Bone Marrow Transplant 1996 17: (Suppl. 2) S72 (Abstr.)

    Google Scholar 

  42. Shimoda K, Okamura S, Inaba S et al. Granulocyte colony-stimulating factor and platelet aggregation (letter) Lancet 1993 341: 633

    Article  CAS  PubMed  Google Scholar 

  43. Avenarius HJ, Freund M, Deinhardt J, Pilowoda H . Effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on circulating platelets Ann Hematol 1992 65: 6 9

    Article  CAS  PubMed  Google Scholar 

  44. Anderlini P, Przepiorka D, Seong D et al. Transient neutropenia in normal donors after G-CSF mobilization and stem cell apheresis Br J Haematol 1996 94: 155 158

    Article  CAS  PubMed  Google Scholar 

  45. Stroncek DF, Clay ME, Smith J et al. Changes in blood counts following the administration of granulocyte-colony-stimulating factor and the collection of peripheral blood stem cells from healthy donors Transfusion 1996 36: 596 600

    Article  CAS  PubMed  Google Scholar 

  46. Link H, Arseniev L, Bähre O et al. Transplantation of allogeneic CD34+ cells Blood 1996 87: 4903 4909

    CAS  PubMed  Google Scholar 

  47. Bensinger WI, Buckner CD, Shannon-Dorcy K et al. Transplantation of allogeneic CD34+ peripheral blood stem cells in patients with advanced hematologic malignancy Blood 1996 88: 4132 4138

    CAS  PubMed  Google Scholar 

  48. Wiesneth M, Schreiner T, Friedrich W et al. Mobilization and collection of allogeneic peripheral blood progenitor cells for transplantation Bone Marrow Transplant 1998 21: (Suppl. 3) S21 S24

    PubMed  Google Scholar 

  49. Arbona C, Prosper F, Benet I et al. Comparison between once a day vs twice a day G-CSF for mobilization of peripheral blood progenitor cells (PBPC) in normal donors for allogeneic PBPC transplantation Bone Marrow Transplant 1998 22: 39 45

    Article  CAS  PubMed  Google Scholar 

  50. Engelhardt M, Bertz H, Afting M et al. High-versus standard-dose filgrastim (rhG-CSF) for mobilization of peripheral-blood progenitor cells from allogeneic donors and CD34(+) immunoselection J Clin Oncol 1999 7: 2160 2172

    Article  Google Scholar 

  51. Martinez C, Urbano-Izpizua A, Marin P et al. Efficacy and toxicity of a high-dose G-CSF schedule for peripheral blood progenitor cell mobilization in healthy donors Bone Marrow Transplant 1999 24: 1273 1278

    Article  CAS  PubMed  Google Scholar 

  52. Anderlini P, Donato M, Lauppe MJ et al. A comparative study of once-daily versus twice-daily filgrastim administration for the mobilization and collection of CD34+ Peripheral blood progenitor cells in normal donors Br J Haematol 2000 109: 770 772

    Article  CAS  PubMed  Google Scholar 

  53. Anderlini P, Przepiorka D, Körbling, Champlin R . Blood stem cell procurement: donor safety issues Bone Marrow Transplant 1998 21: (Suppl. 3) S35 S39

    PubMed  Google Scholar 

  54. Fischer J, Frick M, Herda A et al. Primary unrelated allografting by G-CSF mobilised PBPC Bone Marrow Transplant 1998 21: (Suppl. 3) S112

    Article  Google Scholar 

  55. Passos-Coelho JL . Braine HG, Wright SK et al. Large volume leukapheresis using regional citrate anticoagulation to collect peripheral blood progenitor cells J Hematother 1995 4: 11 19

    Article  CAS  PubMed  Google Scholar 

  56. Kobbe G, Soehngen D, Heyll A et al. Large volume leukapheresis maximizes the progenitor cell yield for allogeneic peripheral blood progenitor donation J Hematother 1997 6: 125 131

    Article  CAS  PubMed  Google Scholar 

  57. Freedman MH . Safety of long-term administration of granulocyte colony-stimulating factor for severe chronic neutropenia Curr Opin Hematol 1997 4: 217 224

    Article  CAS  PubMed  Google Scholar 

  58. Falkenburg JHF . G-CSF: early benefits but late risks? Blood 2001 97: 2194

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This study was supported by Bergliot and Sigurd Skaugen's ‘Fond til bekjempelse av kreft’. We also thank the nurses at the Department of Haematology at Rikshospitalet, Oslo for their excellent co-operation and Ellen Finsberg for graphs.

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Authors and Affiliations

  1. Medical Department, Rikshospitalet University Hospital, Oslo, Norway

    D Heldal, L Brinch, G Tjønnfjord & SA Evensen

  2. Institute of Immunology, Rikshospitalet University Hospital, Oslo, Norway

    BG Solheim & T Egeland

  3. Department of Clinical Chemistry, Rikshospitalet University Hospital, Oslo, Norway

    G Gadeholt

  4. Department of Surgery, Rikshospitalet University Hospital, Oslo, Norway

    D Albrechtsen

  5. Section of Clinical Epidemiology, Rikshospitalet University Hospital, Oslo, Norway

    G Aamodt

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Heldal, D., Brinch, L., Tjønnfjord, G. et al. Donation of stem cells from blood or bone marrow: results of a randomised study of safety and complaints. Bone Marrow Transplant 29, 479–486 (2002). https://doi.org/10.1038/sj.bmt.1703418

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