No Major Complications In Children After Stem Cell Donation At One Year Follow-Up: EBMT Pediatric Diseases Working Party Study

We previously reported (Styczynski et al, Blood, 2012) that hematopoietic stem cells (HSC) collection from bone marrow (BM) or peripheral blood (PB) in pediatric sibling donors is safe, however there is a risk of mild, short-term early side effects. No data are available so far on follow-up in children donating HSC.

To analyze donor safety and side effects related to HSC collection from BM or PB in pediatric sibling donors after 1-year.

171 children: 90 male (M), 81 female (F), median age 9.2 (range: 0.7-17.3) yrs, including 45 children’s weight <20 kg, 64 between 20-40 kg, 82 weight >40 kg; 31 donors were <4 yrs, 40 at 4-8 yrs, 100 at age >8 yrs. There were 25 PB donors 9 (PBD) (18 M, 7 F; median age 11.0, range: 1.3-17.3 yrs ) and 146 BM donors (BMD) (72 M, 74 F; median age 8.3, range: 0.7-17.3 yrs).

Data from 14 participating EBMT Centers were registered on specific forms, sent to the PDWP office and statistically analyzed.

During follow-up local pain was reported by 16/161 (9.9%) donors at catheter site (n=1) or collection site in 16 (14/137 BM; 2/24 PB, ns). 14 (8.1%) donors complained for pain persistence for 1-6 months (1mo-5, 2mo-5, 3mo-2, 5mo-1, 6mo-1). Late vomiting was observed in 7/163 (4.3%) (BMD only), and hematuria in 1 donor. Fever episodes were observed in 21/164 (12.8%) (21/140 BMD, p=0.045), lower respiratory tract infection in 3/164 (1.8%) (1/140 BMD, 2/25 PBD, p=0.056), upper respiratory tract infection in 21/171 (12.3%) (21/146 BM, p=0.046) and urinary tract infection in 5/171 (2.9%) (5/146 BMD, ns). No other infections (including gastroenterocolitis or hepatitis) were reported. Anemia was diagnosed in 6/164 (3.6%) (6/140 BMD, ns). At 1 year follow-up iron was supplemented in 24/164 (14.6%) (22/140 BMD, 2/24 PBD, ns) and folinic acid in 2/163 (1.2%) (BMD only). No other hematological problems (including thrombotic events) were reported. One donor was diagnosed for chronic disease (0.6%) (asthma), 4 (2.4%) had another hospital stay: physiotherapy (n=1), circumcision (n=1), plastic surgery due to an accident (n=1), and donation for MSC (n=1). Assessment of profile of psychological status consisted of a six item questionnaire. At 1-year follow-up, donors felt helpful in 132/154 (85.7%) cases (BMD 109/130, PBD 23/24, ns); happy in 117/149 (78.5%) cases (BMD 93/125, PBD 24/24, p=0.011); proud in 113/147 (76.8%) cases (BMD 91/124, PBD 22/23, p=0.039); depressed in 11/147 (7.5%) cases (BMD 11/124, PBD 0/23, ns) and responsible for recipient in 97/145 (66.9%) cases (BMD 83/122, PBD 14/23, ns). Willingness for subsequent HSC donation was reported by 113/147 (76.8%) children (BMD 94/125, PBD 19/22, ns).

At one-year follow-up after BM or PB HSC collection in pediatric sibling donors no major side effects were reported, however there is a risk of mild side effects. A donor registry should document and evaluate the course of minors who donate hematopoietic stem cells to better define possible risk factors of BM or PBSC harvest.

Dreger:Riemser Pharma : Consultancy, Honoraria, Research Funding.