Marrow harvesting from normal donors

Abstract

The experience at a single institution in harvesting marrow for allogeneic transplantation on 1,270 occasions from 1,160 normal donors is presented in detail, together with an analysis of all the donor complications. Four donors were less than 2 years old, and the youngest was 6 1/2 months. No special difficulties were encountered with these young donors. Hospitalization time was three days or less for 99% of the procedures. Six donors had life-threatening complications; three of a cardiopulmonary and two of an infectious nature, and one cerebrovascular embolic episode. Significant operative site morbidity, usually transient neuropathies, occurred in ten procedures. Ten percent of the donations were associated with transient postoperative fever of unknown origin. Increasing donor age was associated with a reduction of the cellularity of the marrow harvest. The use of stored autologous blood permitted the avoidance of blood bank transfusion in 81% of males, 69% of females, and 50% of children. It was concluded that the procedure was associated with a very low risk of complication, but that the involvement of normal donors in such an operation justifies stringent monitoring.

Cord blood stem cell transplantation for haemoglobinopathies

“…In SCD, reports of unrelated donor HSCT are scarce, presumably due to medical reluctance to proceed or previous experience of unfavourable outcomes (Shenoy, 2007). This limited experience of unrelated marrow donor HSCT, together with the growing interest in considering patients >17 years for HSCT (Gaziev et al, 2005;Rund & Rachmilewitz, 1995) and the ethical dilemmas surrounding the use of healthy child marrow donors (Buckner et al, 1984;Chan et al, 1996;Pulsipher et al, 2006), has led to increasing numbers of CBT for haemoglobinopathies.…”

Collection of peripheral blood stem cells from normal donors 60 years of age or older

“…RhG-CSF-mobilized peripheral blood stem cells (PBSCs) are rapidly becoming an accepted alternative to marrow for allografting in patients with haematological malignancies (Goldman, 1995;Russell et al, 1996). As donor age tends to match patient age and most institutions do not routinely transplant patients older than 50-55 years of age, information on the feasibility of employing older (у60 years) marrow donors is limited (Buckner et al, 1984;Doney et al, 1995) and data on stem cell collection from 'elderly' normal donors are even more scarce. It has been reported that normal 'elderly' donors mobilize progenitor cells less effectively than younger ones despite comparable neutrophilic responses (Chatta et al, 1994).…”

The impact of donor age and sex on the nucleated cell count and CD34 count in healthy bone marrow donors

“…There was no statistical evaluation performed to see whether this decrease in NCC was significant with increasing age. The CD34 count of the product was also not reported in that report (11). When gender is not taken into consideration, our statistical evaluation showed that the NCC, as well as the CD34 count, decreases significantly with age.…”