Eighteen Years Experience of Granulocyte Donations - Acceptable Donor Safety?

Background. Granulocyte transfusions are given to patients with life-threatening infections, refractory to treatment. The donors are stimulated with corticosteroids +/- G-CSF. However, data regarding the donor’s safety is sparse. The objective was therefore to evaluate short and long term adverse events (AE) in stimulated donors.

Study design and methods. All consecutive granulocyte donors 1994-2012 were identified through our registry. Data were evaluated for the number of aphereses, stimulation therapy, AE, blood values post donation and recent status from the donation records.

Results. 154 volunteer donors were mobilized for 359 collections. Age at first granulocyte donation was 43 years (median; range 19-64 years). Follow-up was 60 months (median; range 0-229 months). The dose G-CSF per collection was 3.8 ug/kg body weight (median; range 1.6-6.0 ug/kg). Sedimentation agent was HES. Short term AE were mild. Blood values 4 weeks post donation with minor reductions/elevations mostly resolved in later donations. Fourteen donors were excluded from the registry due to hypertension (4), diabetes (2), atrial fladder (1), ca mammae (1), ca in situ urethra (1), MGUS (1), thrombosis (1), anaphylaxis (1), primary biliary cirrhosis (1), unknown (1). Three donors are deceased due to diabetes, acute myocardial infarction and unknown cause. Time from first donation to exclusion was 37 months (median; range 1-198). All donors except one were excluded/died at least 6 months after the first granulocyte donation.

Conclusion. No serious short term AE were observed. Due to the variability of diagnoses among excluded /deceased donors, we propose that it is less likely that granulocyte donations have a causative impact on these donors’ exclusion or death.