Mobilized blood cells vs bone marrow harvest: experience compared in 171 donors with particular reference to pain and fatigue

Abstract

Summary:This prospective study compared the donor experience of blood cell (BC) mobilization and leukapheresis (n ¼ 116) with that of bone marrow (BM) harvest (n ¼ 55). Internal jugular catheters were inserted electively in 89% of BC donors. Most (80%) BM donors had a harvest with general anesthesia; 20% had epidural or spinal anesthesia. Pain and fatigue were frequent with both procedures and were compared in responses to questionnaires. A total of 85% of BM donors reported moderate or severe pain compared with 68% of BC donors (P ¼ 0.02). The median duration of pain was 14 days for BM donors compared with 3 days after BC mobilization (Po0.0001). More BM donors had pain for more than 7 days (75% vs 0%, Po0.0001). Severe fatigue was experienced by more BM donors (49 vs 16%, Po0.0001). Fatigue lasted significantly longer in BM donors (median 11 vs 4 days, Po0.0001) and more BM donors were fatigued for more than 1 week (69 vs 0%, Po0.0001). A total of 11 donors had both BM and BC collection; seven preferred the latter. Simply considered with respect to pain and fatigue, BC donation appears better tolerated by donors. However, there are other sequelae of both influencing the acceptability for individual donors.

The role of donor characteristics and post-granulocyte colony-stimulating factor white blood cell counts in predicting the adverse events and yields of stem cell mobilization

“…The common adverse events related to G-CSF were bone pain (64.9%), myalgia/arthralgia (58.2%), fatigue (44.1%) and headache (33.0%). The incidences were generally comparable to previous reports [2,3,5,[8][9][10][11][12][13][14] (Supplementary table). Although there are some variations between different studies, the differences might be due to the reported symptoms that were subjective and mostly mild in all studies.…”

Regeneration, health status and quality of life after rhG-CSF-stimulated stem cell collection in healthy donors: a cross-sectional study

“…1 Since then, cytokine-mobilized PBPCs collected from healthy sibling or unrelated donors are increasingly used as stem-cell source in the allogeneic setting. 2 PBPCs have been shown to be superior to BMderived stem cells during the early post transplant course. 3,4 The high CD34 þ cell yield in PBPC grafts significantly shortens the post transplant aplasia and the need for blood component support, especially platelets.…”

Pain syndromes in the setting of haematopoietic stem cell transplantation for haematological malignancies

“…In addition, pain lasting more than 7 days was reported by a larger number of marrow donors than by those who underwent blood cell collection. 4 A comparative study reported that the incidence of bone pain was 65.3% in donors receiving lenograstim and 61.9% in those stimulated with filgrastim. 10 A rare but painful acute complication of filgrastim stimulation, seen in patients 11 and healthy donors, 12 is rupture of the spleen.…”

“…3 Stem cell donors may experience pain from mobilization of haematopoietic stem cells or collection of bone marrow. 4 The major cause of pain in HSCT recipients is a result of injury to mucosal tissues induced by the conditioning regimen. 5 In addition, pain in HSCT recipients may be due to infection, acute and chronic GVHD as well as adverse effects of some of the drugs administered for GVHD prophylaxis.…”