University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, UT;
Center for International Blood and Marrow Transplant Research, Minneapolis, MN;
Blood. 2014 Jun 5;123(23):3655-63. doi: 10.1182/blood-2013-12-542464. Epub 2014 Apr 15.
We compared serious early and late events experienced by 2726 bone marrow (BM) and 6768 peripheral blood stem cell (PBSC) donors who underwent collection of PBSC or BM between 2004 and 2009 as part of a prospective study through the National Marrow Donor Program. Standardized FDA definitions for serious adverse events (SAEs) were used, and all events were reviewed by an independent physician panel. BM donors had an increased risk for SAEs (2.38% for BM vs 0.56% for PBSC; odds ratio [OR], 4.13; P < .001), and women were twice as likely to experience an SAE (OR for men, 0.50; P = .005). Restricting the analysis to life-threatening, unexpected, or chronic/disabling events, BM donors maintained an increased risk for SAEs (0.99% for BM vs 0.31% for PBSC; OR, 3.20; P < .001). Notably, the incidence of cancer, autoimmune illness, and thrombosis after donation was similar in BM vs PBSC donors. In addition, cancer incidence in PBSC donors was less than that reported in the general population (Surveillance, Epidemiology, and End Results Program database). In conclusion, SAEs after donation are rare but more often occurred in BM donors and women. In addition, there was no evidence of increased risk for cancer, autoimmune illness, and stroke in donors receiving granulocyte colony-stimulating factor during this period of observation.
我们比较了 2726 名骨髓(BM)和 6768 名外周血干细胞(PBSC)供者在 2004 年至 2009 年期间接受 PBSC 或 BM 采集期间经历的严重早期和晚期事件,这些供者是通过国家骨髓捐献者计划进行的前瞻性研究的一部分。使用了 FDA 对严重不良事件(SAE)的标准化定义,所有事件均由独立医生小组进行审查。BM 供者发生 SAE 的风险增加(BM 为 2.38%,PBSC 为 0.56%;比值比[OR],4.13;P <.001),女性发生 SAE 的可能性是男性的两倍(男性的 OR,0.50;P =.005)。将分析限制在危及生命、意外或慢性/致残的事件中,BM 供者仍然存在 SAE 的风险增加(BM 为 0.99%,PBSC 为 0.31%;OR,3.20;P <.001)。值得注意的是,BM 与 PBSC 供者在捐赠后发生癌症、自身免疫性疾病和血栓形成的发生率相似。此外,PBSC 供者的癌症发病率低于一般人群(监测、流行病学和最终结果计划数据库)。总之,捐赠后发生 SAE 的情况很少见,但在 BM 供者和女性中更为常见。此外,在观察期间接受粒细胞集落刺激因子的供者没有证据表明癌症、自身免疫性疾病和中风的风险增加。