Acute toxicities of unrelated bone marrow versus peripheral blood stem cell donation: results of a prospective trial from the NMDP

Michael A. Pulsipher, Pintip Chitphakdithai, Brent R. Logan, Bronwen E. Shaw, John R. Wingard, Hillard M. Lazarus, Edmund K. Waller, Matthew Seftel, David F. Stroncek, Angela M. Lopez, Dipnarine Maharaj, Peiman Hematti, Paul V. O'Donnell, Alison W. Loren, Susan F. Leitman, Paolo Anderlini, Steven C. Goldstein, John E. Levine, Willis H. Navarro, John P. Miller and Dennis L. Confer
This article has an Erratum 123(12):1970


Although peripheral blood stem cells (PBSC) have replaced bone marrow (BM) as the most common unrelated donor progenitor cell product collected, a direct comparison of concurrent PBSC vs. BM donation experiences has not been performed. We report a prospective study of 2726 BM and 6768 PBSC donors who underwent collection from 2004-2009. Pain and toxicities were assessed at baseline, during G-CSF administration, on the day of collection, within 48 hours of donation, and weekly until full recovery. Peak levels of pain and toxicities did not differ between the two donation processes for most donors. Among obese donors, PBSC donors were at increased risk of grade 2-4 pain as well as grade 2-4 toxicities during the peri-collection period. In contrast, BM donors were more likely to experience grade 2-4 toxicities at one week and pain at one week and one month after the procedure. BM donors experienced slower recovery, with 3% still not fully recovered at 24 weeks, while 100% of PBSC donors had recovered. Other factors associated with toxicity included obesity, increasing age, and female gender. In summary, this study provides extensive detail regarding individualized risk patterns of PBSC vs. BM donation toxicity, suggesting donor profiles that can be targeted with interventions to minimize toxicity.

  • Submitted March 19, 2012.
  • Accepted August 11, 2012.