Rowley S D, Donaldson G, Lilleby K, Bensinger W I, Appelbaum F R
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Blood. 2001 May 1;97(9):2541-8. doi: 10.1182/blood.v97.9.2541.
The experiences of 69 (38 marrow and 31 peripheral blood stem cell [PBSC]) donors participating in a randomized trial comparing allogeneic bone marrow with PBSC transplantation were studied. Marrow was collected by means of standard harvest techniques and general or regional anesthesia. PBSC donors were treated with 5 to 7 days of filgrastim at a dose of 16 microg/kg/d and underwent 1 to 3 days of apheresis to obtain 5 x 10(6) CD34(+) cells per kilogram recipient weight. Donors completed questionnaires describing their health experiences before, during, and then weekly after donation until return to baseline status. Both marrow and PBSC donors reported minimal fluctuation in symptoms measuring emotional status. In contrast, both groups of donors reported deterioration in physical status starting with administration of filgrastim (PBSC donors) or after the marrow collection procedure. The symptom burden reported was similar, with pain a prominent symptom for both groups. Equivalent mean levels of maximal pain, average pain, and pain duration through the day were reported, although toxicity peaks occurred at different time points during the harvest procedures. All PBSC donors but only 79% of marrow donors reported good physical status by 14 days after the harvest procedures. These data demonstrate similar levels of physical discomfort for hematopoietic stem cell donors regardless of the collection procedure used, but a quicker resolution of symptoms for PBSC donors.
对69名参与比较异基因骨髓移植与外周血干细胞(PBSC)移植的随机试验的供者(38名骨髓供者和31名外周血干细胞供者)的经历进行了研究。骨髓通过标准采集技术及全身或局部麻醉进行采集。外周血干细胞供者接受5至7天剂量为16微克/千克/天的非格司亭治疗,并进行1至3天的单采术,以每千克受者体重获取5×10⁶个CD34⁺细胞。供者完成问卷,描述其在捐献前、捐献期间以及捐献后每周直至恢复至基线状态时的健康经历。骨髓供者和外周血干细胞供者均报告称,衡量情绪状态的症状波动极小。相比之下,两组供者均报告称,从给予非格司亭(外周血干细胞供者)或骨髓采集程序后开始,身体状态出现恶化。报告的症状负担相似,疼痛是两组的主要症状。尽管在采集程序的不同时间点出现毒性峰值,但报告的最大疼痛、平均疼痛及全天疼痛持续时间的平均水平相当。所有外周血干细胞供者均报告在采集程序后14天时身体状态良好,但骨髓供者只有79%报告如此。这些数据表明,无论采用何种采集程序,造血干细胞供者的身体不适程度相似,但外周血干细胞供者的症状缓解更快。