Analysis of the Effect of Race, Socioeconomic Status, and Center Size on Unrelated National Marrow Donor Program Donor Outcomes: Donor Toxicities Are More Common at Low-Volume Bone Marrow Collection Centers

Biol Blood Marrow Transplant. 2015 Oct;21(10):1830-8. doi: 10.1016/j.bbmt.2015.06.013. Epub 2015 Jun 23.

Abstract

Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index, and age in unrelated donors undergoing collection at National Marrow Donor Program centers. We hypothesized that other important factors (race, socioeconomic status [SES], and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2726 bone marrow (BM) and 6768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week after donation (P = .017). For BM donors, black males reported significantly higher levels of pain (OR, 1.90; CI, 1.14 to 3.19; P = .015). No differences were noted by SES group. BM donors from low-volume centers reported more toxicity (OR, 2.09; CI, 1.26 to 3.46; P = .006). In conclusion, race and SES have a minimal effect on donation-associated symptoms. However, donors from centers performing ≤ 1 BM collection every 2 months have more symptoms after BM donation. Approaches should be developed by registries and low-volume centers to address this issue.

Keywords: Bone marrow; Donor center; Donor toxicities; PBSC; Race; Socioeconomic status; Unrelated donor.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia / adverse effects
  • Anesthesia / methods
  • Blood Cell Count
  • Body Mass Index
  • Bone Marrow Transplantation*
  • Cytomegalovirus Infections / epidemiology
  • Female
  • Filgrastim / adverse effects
  • Hospitals, High-Volume / statistics & numerical data*
  • Hospitals, Low-Volume / statistics & numerical data*
  • Humans
  • Income / statistics & numerical data
  • Male
  • Middle Aged
  • Pain / epidemiology
  • Pain / etiology
  • Peripheral Blood Stem Cell Transplantation*
  • Racial Groups*
  • Social Class*
  • Tissue Donors* / statistics & numerical data
  • Tissue and Organ Harvesting / adverse effects*
  • Young Adult

Substances

  • Filgrastim