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Shorter Interdonation Interval Contributes to Lower Cell Counts in Subsequent Stem Cell Donations.
Sandhya R Panch1, Brent Logan2, Jennifer A Sees3
1Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, Maryland.
Transplantation and Cellular Therapy
|April 6, 2021
Summary
Second-time hematopoietic stem cell donors, particularly for peripheral blood stem cell donations, experienced lower yields. Factors like shorter intervals between donations and lower BMI impacted stem cell collection success.
Area of Science:
- Hematology
- Transplantation Immunology
- Stem Cell Biology
Background:
- Approximately 7% of hematopoietic stem cell donors are requested for a second donation.
- Previous research indicates similar donation-related symptoms for first and subsequent donations.
- Limited data exists on stem cell mobilization and yield differences for repeat peripheral blood stem cell (PBSC) and bone marrow (BM) collections.
Purpose of the Study:
- To investigate differences in CD34+ cell yields and total nucleated cell (TNC) concentrations for subsequent PBSC and BM donations compared to first donations.
- To identify factors influencing stem cell yields in healthy, unrelated, second-time donors.
Main Methods:
- Retrospective analysis of data from the Center for International Blood and Marrow Transplant Research database.
- Inclusion of 513 PBSC and 43 BM donors who made a second donation between 2006 and 2017 via the National Marrow Donor Program.
- Comparison of stem cell yields and related factors between first and second donations.
Main Results:
- Second-time PBSC donors showed significantly lower preapheresis peripheral blood CD34+ cell counts and collection yields compared to their first donation (P=.03 and P=.02, respectively).
- Factors associated with decreased yields in subsequent PBSC donations included shorter interdonation intervals, lower body mass index (BMI), and lower total G-CSF dose.
- Repeat BM donors exhibited lower TNC concentration at the second donation; however, this subgroup was too small for further analysis.
- Suboptimal stem cell yields at the first donation often correlated with suboptimal yields at subsequent donations.
Conclusions:
- Subsequent PBSC and BM donations may result in lower stem cell yields compared to initial collections.
- Optimizing stem cell yields for repeat donations may involve increasing interdonation intervals and considering donor BMI.
- Adjusting G-CSF dosage within permissible limits could potentially improve PBSC yields in repeat donors.
