Department of Transfusion Medicine, Cell Processing Section, Clinical Center, National Institutes of Health, Bethesda, Maryland.
Center for International Blood and Bone Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
Biol Blood Marrow Transplant. 2018 Jan;24(1):175-184. doi: 10.1016/j.bbmt.2017.09.013. Epub 2017 Sep 25.
Little is known about the experiences of individuals donating peripheral blood stem cells (PBSCs) or marrow for a second time. To study this, unrelated donors making a second donation through the National Marrow Donor Program between 2004 and 2013 were evaluated. Experiences of second-time donors giving marrow (n = 118: first donation was PBSC in 76 and marrow in 42) were compared with those making only 1 marrow donation (n = 5829). Experiences of second-time donors giving PBSCs (n = 602) (first donation was PBSCs in 362; marrow in 240) were compared to first-time PBSC donors (n = 16,095). For donors giving a second PBSC or marrow donation there were no significant differences in maximum skeletal pain, maximum symptoms measured by an established modified toxicity criteria, and recovery time compared with those who donated only once. Notably, the yield of marrow nucleated cells and PBSC CD34 cells with second donations was less. As previously noted with single first-time donations, female (PBSCs and marrow) and obese donors (PBSCs) had higher skeletal pain and/or toxicity with a second donation. PBSC donors who experienced high levels of pain or toxicity with the first donation also experienced high levels of these symptoms with their second donation and slower recovery times. In conclusion, for most donors second donation experiences were similar to first donation experiences, but CD34 yields were less. Knowledge of the donor's first experience and stem cell yields may help centers decide whether second donations are appropriate and institute measures to improve donor experiences.
关于个体捐献外周血造血干细胞(PBSC)或骨髓进行第二次捐献的经历,人们知之甚少。为了研究这一点,对 2004 年至 2013 年间通过国家骨髓捐献者计划进行第二次捐献的无关供者进行了评估。比较了进行第二次骨髓捐献(n=118:第一次捐献为 PBSC 的有 76 人,为骨髓的有 42 人)和仅进行 1 次骨髓捐献(n=5829)供者的经历。比较了进行第二次 PBSC 捐献(n=602)(第一次捐献为 PBSC 的有 362 人,为骨髓的有 240 人)和首次 PBSC 捐献者(n=16095)的经历。与仅捐献一次的供者相比,进行第二次 PBSC 或骨髓捐献的供者在最大骨骼疼痛、通过既定改良毒性标准测量的最大症状和恢复时间方面没有显著差异。值得注意的是,与首次捐献相比,第二次捐献时骨髓有核细胞和 PBSC CD34 细胞的产量较低。与单次首次捐献一样,女性(PBSC 和骨髓)和肥胖供者(PBSC)在第二次捐献时会出现更高水平的骨骼疼痛和/或毒性。在首次捐献中经历过高水平疼痛或毒性的 PBSC 供者,在第二次捐献中也会经历高水平的这些症状和更慢的恢复时间。总之,对于大多数供者来说,第二次捐献的经历与首次捐献的经历相似,但 CD34 的产量较低。了解供者的首次捐献经历和干细胞产量,可能有助于中心决定是否进行第二次捐献,并采取措施改善供者的体验。