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Adverse Occurrence type:
Children commonly report pain (71%) and symptoms (59%) 24-48 hours after bone marrow donation. Incidence of grades 2-4/3-4 skeletal pain peri-collection and post donation increased with age (13-17 yr: 44% grade 2-4, 13% grade 3-4). Incidence of grades 2-4/3-4 body symptoms (according to modified toxicity criteria) peri-collection and post donation: BM donors older/younger cohort - fatigue (41% vs 27%, dizziness (29% vs 12%) and nausea (25% vs 14%); PB donors did not report modified toxicity criteria (symptoms with collection). Recovery to pre-donation levels by 1 year post. A higher percentage of donors report grade 1-2 pain at 1 year compared to pre-donation. Older donors had higher risk of failure to return to pre-donation levels at 1 year, females age 13-17 are at risk for grade 2-4 pain at 1 year.
Time to detection:
Peri-donation until 1 year post donation
Alerting signals, symptoms, evidence of occurrence:
Incidence of blood transfusion after BM donation was 4% (0-6 yr) and 2% (7-12 yr). 9% of 9-13 yr olds received autologous blood transfusion, no allo transfusions were reported. Serious adverse events related to donation: 5 yr old donor with possible aspiration after emesis post-extubation after BM harvest; 13 yr old donor with seizure after rhythm abnormalities and hypertension (known history of seizure disorder).
Higher Risks of Toxicity and Incomplete Recovery in 13- To 17-Year-Old Females After Marrow Donation: RDSafe Peds Results. Pulsipher et al, Biol Blood Marrow Transplant. 2019 May;25(5):955-964
Expert comments for publication:
This study shows that side effects of stem cell donation by young donors can persist up til one year after donation (and probably younger, but not in the scope of this research project). Also the differences between younger an older donors, and male/female donors are informative and useful for the preparation of pediatric stem cell donors.