Apheresis of Hematopoietic Progenitor Cell (HPC) From Allogeneic Donors ≥60 Years of Age.

Abstract 4226

There has been reluctance to collect apheresis HPC grafts from donors of age 60 and beyond. This is predicated on concern over relative frailty, poor venous access, reduced potential for HPC mobilization, and reduced potential for stable engraftment of HPC transplant. We have expanded our transplant eligibility into patients beyond the age of 60, with the concomitant acceptance of matched sibling donors of similar age. We have reviewed 96 consecutive sibling donors, 19 of whom were of age ≥60 years at the time of collection. All donors were collected using Gambro Spectra apheresis instruments, and the volume of blood pheresed was gauged to target a CD34 dose of 5-10 million per Kg of recipient weight. We have found the following:

These results suggest that donors of age ≥60 years may be successfully collected, and that the resultant grafts can be expected to produce successful transplants. There is not a higher toxicity rate or need for catheter insertion associated with the collections in the older age group. There is a clear trend, however, to reduced mobilization of CD34+ cells, as reflected in the need for more collections, and fewer CD34+ cells per blood volume leukopheresed. In spite of this, sufficient cells to produce functional grafts were collected from all donors, although a limited number of donors in both age categories failed to collect a full 5e+6 CD34/Kg. We conclude that in the context of an aging demographic, allograft donors of age ≥60 may be successfully employed for HPC collection. Further, we propose that the application of plerixafor in ≥60 year old donors should be investigated in the context of a growing need to collect allografts from donors in this age group.