Transfusion Medicine Service, Apheresis Unit, IRCCS Foundation, National Institute for the Study and Treatment of Cancer, Milan.
Blood Transfus. 2012 Oct;10(4):440-7. doi: 10.2450/2012.0140-11. Epub 2012 Jul 12.
Recommendations on eligibility criteria for donation of haematopoietic stem cells, management of collection of the cells and follow-up mainly concern unrelated donors. The aim of this study was to analyse the screening of related donors and collection practices at different Italian apheresis centres.
A questionnaire regarding eligibility criteria for related haematopoietic stem cell donors, their peripheral blood collections and early follow-up was sent to several apheresis units. Data from the full charts of 500 candidates, screened between May 2005 and December 2009, were retrospectively evaluated.
The donors' records, eligibility criteria, collections and follow-up are managed differently in each centre. Of the 500 evaluable candidates (51.2% male, 49.8% female; median age 47 years, range 13-77), 26.4% underwent thorough screening according to Italian Bone Marrow Donor Registry standards, while local protocols were applied to 73.6%; 91 candidates (18.2%) proved ineligible for donation. In the end, 352 donors (53.4% male, 46.6% female; median age 45 years, range 16-76) underwent 508 leukaphereses. Central venous catheters were used in 8.0% of donors, mainly in one centre. Unsuitable pre-apheresis peripheral blood parameters were reported in 38.7% of the aphereses. Leukapheresis-related adverse events were recorded in 23.0% of the procedures, with a drop-out rate of 0.2% for severe events. No donation-related fatalities occurred. The CD34+ cell yield was <2×10(6)/kg of recipient's body weight from 1.1% of donors ≥70 years old.
More uniformity in donor screening procedures, management of peripheral blood collection and follow-up should be planned at a national level to maximise the safety of related donors.
有关造血干细胞捐献者资格标准、细胞采集管理和随访的建议主要涉及无关供者。本研究的目的是分析不同意大利单采中心相关供者的筛选和采集实践。
向多个单采单位发送了一份有关相关造血干细胞供者资格标准、其外周血采集和早期随访的调查问卷。回顾性评估了 2005 年 5 月至 2009 年 12 月期间筛选的 500 名候选者的完整病历数据。
各中心对供者记录、资格标准、采集和随访的管理方式各不相同。在 500 名可评估候选者中（51.2%为男性，49.8%为女性；中位年龄 47 岁，范围 13-77 岁），26.4%按照意大利骨髓捐献者登记处标准进行了全面筛查，而 73.6%采用了当地方案；91 名候选者（18.2%）因不符合捐献标准而被排除。最终，352 名供者（53.4%为男性，46.6%为女性；中位年龄 45 岁，范围 16-76 岁）进行了 508 次白细胞单采。在 8.0%的供者中使用了中心静脉导管，主要在一个中心使用。38.7%的白细胞单采术出现了不适于采集前外周血参数。在 23.0%的手术中记录到白细胞单采相关不良事件，严重事件的退出率为 0.2%。无与捐献相关的死亡事件发生。从年龄≥70 岁的 1.1%的供者中获得的 CD34+细胞产量<2×10(6)/kg 受者体重。
应在国家层面上计划更加统一的供者筛选程序、外周血采集和随访管理，以最大限度地提高相关供者的安全性。
