Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience: Report from the Related Donor Safety Study

Michael A. Pulsipher, Brent R. Logan, Pintip Chitphakdithai, Deidre M. Kiefer, Marcie L. Riches, J. Douglas Rizzo, Paolo Anderlini, Susan F. Leitman, James W. Varni, Hati Kobusingye, Rae Anne M. Besser, John P. Miller, Rebecca J. Drexler, Aly Abdel-Mageed, Ibrahim A. Ahmed, Luke P. Akard, Andrew S. Artz, Edward D. Ball, Ruthee Lu Bayer, Carolyn BigelowBrian J. Bolwell, E. Randolph Broun, Nancy J. Bunin, David C. Delgado, Katharine Duckworth, Christopher C. Dvorak, Theresa E. Hahn, Ann E. Haight, Parameswaran N. Hari, Brandon M. Hayes-Lattin, David A. Jacobsohn, Ann A. Jakubowski, Kimberly A. Kasow, Hillard M. Lazarus, Jane L. Liesveld, Michael Linenberger, Mark R. Litzow, Walter Longo, Margarida Magalhaes-Silverman, John M. McCarty, Joseph P. McGuirk, Shahram Mori, Vinod K. Prasad, Scott D. Rowley, Witold Rybka, Indira Sahdev, Jeffrey R. Schriber, George B. Selby, Paul J. Shaughnessy, Shalini Shenoy, Thomas Spitzer, William T. Tse, Joseph P. Uberti, Madhuri Vusirikala, Edmund K. Waller, Daniel J. Weisdorf, Gregory A. Yanik, Willis H. Navarro, Mary M. Horowitz, Galen E. Switzer, Bronwen E. Shaw, Dennis L. Confer

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The development of reduced-intensity approaches for allogeneic hematopoietic cell transplantation has resulted in growing numbers of older related donors (RDs) of peripheral blood stem cells (PBSCs). The effects of age on donation efficacy, toxicity, and long-term recovery in RDs are poorly understood. To address this we analyzed hematologic variables, pain, donation-related symptoms, and recovery in 1211 PBSC RDs aged 18 to 79 enrolled in the Related Donor Safety Study. RDs aged > 60 had a lower median CD34 + level before apheresis compared with younger RDs (age > 60, 59 × 10 6 /L; age 41 to 60, 81 × 10 6 /L; age 18 to 40, 121 × 10 6 /L; P <.001). This resulted in older donors undergoing more apheresis procedures (49% versus 30% ≥ 2 collections, P <.001) and higher collection volumes (52% versus 32% > 24 L, P <.001), leading to high percentages of donors aged > 60 with postcollection thrombocytopenia <50 × 10 9 /L (26% and 57% after 2 and 3days of collection, respectively). RDs aged 18 to 40 had a higher risk of grades 2 to 4 pain and symptoms pericollection, but donors over age 40 had more persistent pain at 1, 6, and 12 months (odds ratio [OR], 1.7; P = 0.02) and a higher rate of nonrecovery to predonation levels (OR, 1.7; P =.01). Donors reporting comorbidities increased significantly with age, and those with comorbidities that would have led to deferral by National Marrow Donor Program unrelated donor standards had an increased risk for persistent grades 2 to 4 pain (OR, 2.41; P <.001) and failure to recover to predonation baseline for other symptoms (OR, 2.34; P =.004). This information should be used in counseling RDs regarding risk and can assist in developing practice approaches aimed at improving the RD experience for high-risk individuals.

Original languageEnglish (US)
Pages (from-to)699-711
Number of pages13
JournalBiology of Blood and Marrow Transplantation
Volume25
Issue number4
DOIs
StatePublished - Apr 1 2019

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Comorbidity
Tissue Donors
Safety
Odds Ratio
Pain
Peripheral Blood Stem Cells
Unrelated Donors
Blood Component Removal
Cell Transplantation
Thrombocytopenia
Counseling
Bone Marrow

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Pulsipher, Michael A. ; Logan, Brent R. ; Chitphakdithai, Pintip ; Kiefer, Deidre M. ; Riches, Marcie L. ; Rizzo, J. Douglas ; Anderlini, Paolo ; Leitman, Susan F. ; Varni, James W. ; Kobusingye, Hati ; Besser, Rae Anne M. ; Miller, John P. ; Drexler, Rebecca J. ; Abdel-Mageed, Aly ; Ahmed, Ibrahim A. ; Akard, Luke P. ; Artz, Andrew S. ; Ball, Edward D. ; Bayer, Ruthee Lu ; Bigelow, Carolyn ; Bolwell, Brian J. ; Broun, E. Randolph ; Bunin, Nancy J. ; Delgado, David C. ; Duckworth, Katharine ; Dvorak, Christopher C. ; Hahn, Theresa E. ; Haight, Ann E. ; Hari, Parameswaran N. ; Hayes-Lattin, Brandon M. ; Jacobsohn, David A. ; Jakubowski, Ann A. ; Kasow, Kimberly A. ; Lazarus, Hillard M. ; Liesveld, Jane L. ; Linenberger, Michael ; Litzow, Mark R. ; Longo, Walter ; Magalhaes-Silverman, Margarida ; McCarty, John M. ; McGuirk, Joseph P. ; Mori, Shahram ; Prasad, Vinod K. ; Rowley, Scott D. ; Rybka, Witold ; Sahdev, Indira ; Schriber, Jeffrey R. ; Selby, George B. ; Shaughnessy, Paul J. ; Shenoy, Shalini ; Spitzer, Thomas ; Tse, William T. ; Uberti, Joseph P. ; Vusirikala, Madhuri ; Waller, Edmund K. ; Weisdorf, Daniel J. ; Yanik, Gregory A. ; Navarro, Willis H. ; Horowitz, Mary M. ; Switzer, Galen E. ; Shaw, Bronwen E. ; Confer, Dennis L. / Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience : Report from the Related Donor Safety Study. In: Biology of Blood and Marrow Transplantation. 2019 ; Vol. 25, No. 4. pp. 699-711.
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abstract = "The development of reduced-intensity approaches for allogeneic hematopoietic cell transplantation has resulted in growing numbers of older related donors (RDs) of peripheral blood stem cells (PBSCs). The effects of age on donation efficacy, toxicity, and long-term recovery in RDs are poorly understood. To address this we analyzed hematologic variables, pain, donation-related symptoms, and recovery in 1211 PBSC RDs aged 18 to 79 enrolled in the Related Donor Safety Study. RDs aged > 60 had a lower median CD34 + level before apheresis compared with younger RDs (age > 60, 59 × 10 6 /L; age 41 to 60, 81 × 10 6 /L; age 18 to 40, 121 × 10 6 /L; P <.001). This resulted in older donors undergoing more apheresis procedures (49{\%} versus 30{\%} ≥ 2 collections, P <.001) and higher collection volumes (52{\%} versus 32{\%} > 24 L, P <.001), leading to high percentages of donors aged > 60 with postcollection thrombocytopenia <50 × 10 9 /L (26{\%} and 57{\%} after 2 and 3days of collection, respectively). RDs aged 18 to 40 had a higher risk of grades 2 to 4 pain and symptoms pericollection, but donors over age 40 had more persistent pain at 1, 6, and 12 months (odds ratio [OR], 1.7; P = 0.02) and a higher rate of nonrecovery to predonation levels (OR, 1.7; P =.01). Donors reporting comorbidities increased significantly with age, and those with comorbidities that would have led to deferral by National Marrow Donor Program unrelated donor standards had an increased risk for persistent grades 2 to 4 pain (OR, 2.41; P <.001) and failure to recover to predonation baseline for other symptoms (OR, 2.34; P =.004). This information should be used in counseling RDs regarding risk and can assist in developing practice approaches aimed at improving the RD experience for high-risk individuals.",
author = "Pulsipher, {Michael A.} and Logan, {Brent R.} and Pintip Chitphakdithai and Kiefer, {Deidre M.} and Riches, {Marcie L.} and Rizzo, {J. Douglas} and Paolo Anderlini and Leitman, {Susan F.} and Varni, {James W.} and Hati Kobusingye and Besser, {Rae Anne M.} and Miller, {John P.} and Drexler, {Rebecca J.} and Aly Abdel-Mageed and Ahmed, {Ibrahim A.} and Akard, {Luke P.} and Artz, {Andrew S.} and Ball, {Edward D.} and Bayer, {Ruthee Lu} and Carolyn Bigelow and Bolwell, {Brian J.} and Broun, {E. Randolph} and Bunin, {Nancy J.} and Delgado, {David C.} and Katharine Duckworth and Dvorak, {Christopher C.} and Hahn, {Theresa E.} and Haight, {Ann E.} and Hari, {Parameswaran N.} and Hayes-Lattin, {Brandon M.} and Jacobsohn, {David A.} and Jakubowski, {Ann A.} and Kasow, {Kimberly A.} and Lazarus, {Hillard M.} and Liesveld, {Jane L.} and Michael Linenberger and Litzow, {Mark R.} and Walter Longo and Margarida Magalhaes-Silverman and McCarty, {John M.} and McGuirk, {Joseph P.} and Shahram Mori and Prasad, {Vinod K.} and Rowley, {Scott D.} and Witold Rybka and Indira Sahdev and Schriber, {Jeffrey R.} and Selby, {George B.} and Shaughnessy, {Paul J.} and Shalini Shenoy and Thomas Spitzer and Tse, {William T.} and Uberti, {Joseph P.} and Madhuri Vusirikala and Waller, {Edmund K.} and Weisdorf, {Daniel J.} and Yanik, {Gregory A.} and Navarro, {Willis H.} and Horowitz, {Mary M.} and Switzer, {Galen E.} and Shaw, {Bronwen E.} and Confer, {Dennis L.}",
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Pulsipher, MA, Logan, BR, Chitphakdithai, P, Kiefer, DM, Riches, ML, Rizzo, JD, Anderlini, P, Leitman, SF, Varni, JW, Kobusingye, H, Besser, RAM, Miller, JP, Drexler, RJ, Abdel-Mageed, A, Ahmed, IA, Akard, LP, Artz, AS, Ball, ED, Bayer, RL, Bigelow, C, Bolwell, BJ, Broun, ER, Bunin, NJ, Delgado, DC, Duckworth, K, Dvorak, CC, Hahn, TE, Haight, AE, Hari, PN, Hayes-Lattin, BM, Jacobsohn, DA, Jakubowski, AA, Kasow, KA, Lazarus, HM, Liesveld, JL, Linenberger, M, Litzow, MR, Longo, W, Magalhaes-Silverman, M, McCarty, JM, McGuirk, JP, Mori, S, Prasad, VK, Rowley, SD, Rybka, W, Sahdev, I, Schriber, JR, Selby, GB, Shaughnessy, PJ, Shenoy, S, Spitzer, T, Tse, WT, Uberti, JP, Vusirikala, M, Waller, EK, Weisdorf, DJ, Yanik, GA, Navarro, WH, Horowitz, MM, Switzer, GE, Shaw, BE & Confer, DL 2019, 'Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience: Report from the Related Donor Safety Study', Biology of Blood and Marrow Transplantation, vol. 25, no. 4, pp. 699-711. https://doi.org/10.1016/j.bbmt.2018.11.004

Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience : Report from the Related Donor Safety Study. / Pulsipher, Michael A.; Logan, Brent R.; Chitphakdithai, Pintip; Kiefer, Deidre M.; Riches, Marcie L.; Rizzo, J. Douglas; Anderlini, Paolo; Leitman, Susan F.; Varni, James W.; Kobusingye, Hati; Besser, Rae Anne M.; Miller, John P.; Drexler, Rebecca J.; Abdel-Mageed, Aly; Ahmed, Ibrahim A.; Akard, Luke P.; Artz, Andrew S.; Ball, Edward D.; Bayer, Ruthee Lu; Bigelow, Carolyn; Bolwell, Brian J.; Broun, E. Randolph; Bunin, Nancy J.; Delgado, David C.; Duckworth, Katharine; Dvorak, Christopher C.; Hahn, Theresa E.; Haight, Ann E.; Hari, Parameswaran N.; Hayes-Lattin, Brandon M.; Jacobsohn, David A.; Jakubowski, Ann A.; Kasow, Kimberly A.; Lazarus, Hillard M.; Liesveld, Jane L.; Linenberger, Michael; Litzow, Mark R.; Longo, Walter; Magalhaes-Silverman, Margarida; McCarty, John M.; McGuirk, Joseph P.; Mori, Shahram; Prasad, Vinod K.; Rowley, Scott D.; Rybka, Witold; Sahdev, Indira; Schriber, Jeffrey R.; Selby, George B.; Shaughnessy, Paul J.; Shenoy, Shalini; Spitzer, Thomas; Tse, William T.; Uberti, Joseph P.; Vusirikala, Madhuri; Waller, Edmund K.; Weisdorf, Daniel J.; Yanik, Gregory A.; Navarro, Willis H.; Horowitz, Mary M.; Switzer, Galen E.; Shaw, Bronwen E.; Confer, Dennis L.

In: Biology of Blood and Marrow Transplantation, Vol. 25, No. 4, 01.04.2019, p. 699-711.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of Aging and Predonation Comorbidities on the Related Peripheral Blood Stem Cell Donor Experience

T2 - Report from the Related Donor Safety Study

AU - Pulsipher, Michael A.

AU - Logan, Brent R.

AU - Chitphakdithai, Pintip

AU - Kiefer, Deidre M.

AU - Riches, Marcie L.

AU - Rizzo, J. Douglas

AU - Anderlini, Paolo

AU - Leitman, Susan F.

AU - Varni, James W.

AU - Kobusingye, Hati

AU - Besser, Rae Anne M.

AU - Miller, John P.

AU - Drexler, Rebecca J.

AU - Abdel-Mageed, Aly

AU - Ahmed, Ibrahim A.

AU - Akard, Luke P.

AU - Artz, Andrew S.

AU - Ball, Edward D.

AU - Bayer, Ruthee Lu

AU - Bigelow, Carolyn

AU - Bolwell, Brian J.

AU - Broun, E. Randolph

AU - Bunin, Nancy J.

AU - Delgado, David C.

AU - Duckworth, Katharine

AU - Dvorak, Christopher C.

AU - Hahn, Theresa E.

AU - Haight, Ann E.

AU - Hari, Parameswaran N.

AU - Hayes-Lattin, Brandon M.

AU - Jacobsohn, David A.

AU - Jakubowski, Ann A.

AU - Kasow, Kimberly A.

AU - Lazarus, Hillard M.

AU - Liesveld, Jane L.

AU - Linenberger, Michael

AU - Litzow, Mark R.

AU - Longo, Walter

AU - Magalhaes-Silverman, Margarida

AU - McCarty, John M.

AU - McGuirk, Joseph P.

AU - Mori, Shahram

AU - Prasad, Vinod K.

AU - Rowley, Scott D.

AU - Rybka, Witold

AU - Sahdev, Indira

AU - Schriber, Jeffrey R.

AU - Selby, George B.

AU - Shaughnessy, Paul J.

AU - Shenoy, Shalini

AU - Spitzer, Thomas

AU - Tse, William T.

AU - Uberti, Joseph P.

AU - Vusirikala, Madhuri

AU - Waller, Edmund K.

AU - Weisdorf, Daniel J.

AU - Yanik, Gregory A.

AU - Navarro, Willis H.

AU - Horowitz, Mary M.

AU - Switzer, Galen E.

AU - Shaw, Bronwen E.

AU - Confer, Dennis L.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - The development of reduced-intensity approaches for allogeneic hematopoietic cell transplantation has resulted in growing numbers of older related donors (RDs) of peripheral blood stem cells (PBSCs). The effects of age on donation efficacy, toxicity, and long-term recovery in RDs are poorly understood. To address this we analyzed hematologic variables, pain, donation-related symptoms, and recovery in 1211 PBSC RDs aged 18 to 79 enrolled in the Related Donor Safety Study. RDs aged > 60 had a lower median CD34 + level before apheresis compared with younger RDs (age > 60, 59 × 10 6 /L; age 41 to 60, 81 × 10 6 /L; age 18 to 40, 121 × 10 6 /L; P <.001). This resulted in older donors undergoing more apheresis procedures (49% versus 30% ≥ 2 collections, P <.001) and higher collection volumes (52% versus 32% > 24 L, P <.001), leading to high percentages of donors aged > 60 with postcollection thrombocytopenia <50 × 10 9 /L (26% and 57% after 2 and 3days of collection, respectively). RDs aged 18 to 40 had a higher risk of grades 2 to 4 pain and symptoms pericollection, but donors over age 40 had more persistent pain at 1, 6, and 12 months (odds ratio [OR], 1.7; P = 0.02) and a higher rate of nonrecovery to predonation levels (OR, 1.7; P =.01). Donors reporting comorbidities increased significantly with age, and those with comorbidities that would have led to deferral by National Marrow Donor Program unrelated donor standards had an increased risk for persistent grades 2 to 4 pain (OR, 2.41; P <.001) and failure to recover to predonation baseline for other symptoms (OR, 2.34; P =.004). This information should be used in counseling RDs regarding risk and can assist in developing practice approaches aimed at improving the RD experience for high-risk individuals.

AB - The development of reduced-intensity approaches for allogeneic hematopoietic cell transplantation has resulted in growing numbers of older related donors (RDs) of peripheral blood stem cells (PBSCs). The effects of age on donation efficacy, toxicity, and long-term recovery in RDs are poorly understood. To address this we analyzed hematologic variables, pain, donation-related symptoms, and recovery in 1211 PBSC RDs aged 18 to 79 enrolled in the Related Donor Safety Study. RDs aged > 60 had a lower median CD34 + level before apheresis compared with younger RDs (age > 60, 59 × 10 6 /L; age 41 to 60, 81 × 10 6 /L; age 18 to 40, 121 × 10 6 /L; P <.001). This resulted in older donors undergoing more apheresis procedures (49% versus 30% ≥ 2 collections, P <.001) and higher collection volumes (52% versus 32% > 24 L, P <.001), leading to high percentages of donors aged > 60 with postcollection thrombocytopenia <50 × 10 9 /L (26% and 57% after 2 and 3days of collection, respectively). RDs aged 18 to 40 had a higher risk of grades 2 to 4 pain and symptoms pericollection, but donors over age 40 had more persistent pain at 1, 6, and 12 months (odds ratio [OR], 1.7; P = 0.02) and a higher rate of nonrecovery to predonation levels (OR, 1.7; P =.01). Donors reporting comorbidities increased significantly with age, and those with comorbidities that would have led to deferral by National Marrow Donor Program unrelated donor standards had an increased risk for persistent grades 2 to 4 pain (OR, 2.41; P <.001) and failure to recover to predonation baseline for other symptoms (OR, 2.34; P =.004). This information should be used in counseling RDs regarding risk and can assist in developing practice approaches aimed at improving the RD experience for high-risk individuals.

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