Page 220 - 2019_04-Haematologica-web

M.A. Pulsipher et al.
URD involving collection procedures (Table 1). While 90% of URD PBSC donations occurred in a single day, and no collection took more than two days, 30% of RD required two days, and 2% and 1% took three and four days, respectively, with collection for one donor taking place over five days (P<0.001). Notably, more RD were collected with lower volume procedures (<18L, 40% vs. 26%; P<0.001). A major difference in RD versus URD prac- tice was noted in the increase in central venous line place- ment in RD for both female and male donors (female RD 38%, female URD 17%, P<0.001; male RD 12%, male URD 2%, P=0.001). Of note, the differences were not impacted by age, although obesity had an impact in female donors, and number of collection procedures per- formed impacted both male and female donors (Online Supplementary Table S2).
Univariate analyses of bone marrow collection, pain and donation-related symptoms
Figure 1A and B show rates of grades 1-4 skeletal pain and collection-related symptoms in RD and URD before, peri-
donation, and one year after the BM collection procedure. Online Supplementary Figure S1A-D detail locations of pain and types of symptoms experienced. It is notable that 5- 10% of healthy URDs and 10-20% of RDs reported mild pain or symptoms pre-donation. Almost all donors reported some level of pain or symptoms during the procedure; however, because grade 1 pain and symptoms rarely require intervention, we focused our analyses on higher grades. Univariate analyses showed RD to have higher rates of grade 2-4 pain pre-donation (2.4% vs. 0.6%; P=0.043) (Online Supplementary Table S3). Grade 2-4 pain levels at col- lection were similar, but grades 3-4 pain were substantially higher in RD (10% vs. 0.6%; P<0.001). At one year, 10% and 5% of RD versus URD reported grade 2-4 pain (P=0.060). Pre-donation, MTC symptoms were similar in RD and URD. At collection, grade 2-4 and 3-4 symptoms were higher in RD versus URD (24% vs. 17% grade 2-4, 3.3% vs. 0.4% grade 3-4; P=0.049 and 0.002, respectively), with higher rates of dizziness, site reactions, nausea, and syncope in RD (P=0.005, 0.008, 0.021, and 0.028, respec- tively) (Online Supplementary Figure S1C).
A
B
Figure 1. Severity of skeletal pain and highest toxicity level across key body symptoms experienced by first time related versus unrelated bone marrow donors at baseline, two days post donation, and one year post donation. (A) Skeletal pain. (B) Highest toxicity level across key body symptoms.
848
haematologica | 2019; 104(4)