Impact of autologous blood transfusion after bone marrow harvest on unrelated donor's health and outcome: a CIBMTR analysis.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАПоддержка правительства СШАПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Farhadfar Nosha, Murthy Hemant S, Logan Brent R, Sees Jennifer A, Ayas Mouhab, Battiwalla Minoo, Beitinjaneh Amer M, Chhabra Saurabh, Diaz Miguel Angel, Engles Katie, Frangoul Haydar, Ganguly Siddhartha, Gergis Usama, Kamani Nayesh R, Kamble Rammurti T, Kasow Kimberly A, Lazarus Hillard M, Liesveld Jane L, Norkin Maxim, O' Donnell Paul V, Olsson Richard F, Rossmann Susan, Savani Bipin N, Schears Raquel, Seo Sachiko, Solh Melhem M, Spitzer Thomas, Sugrue Michele, Yared Jean A, Linenberger Michael, Schwartz Joseph, Pulsipher Michael A, Shah Nirali N, Switzer Galen E, Confer Dennis L, Shaw Bronwen E, Wingard John R
Аннотация
Pre-harvest autologous blood collection from bone marrow (BM) donors is performed to meet potential post-operative transfusion needs. This study examines the impact of autologous blood transfusion on BM donor's health and safety. The study included first-time unrelated BM donors from the United States whose BM harvest was facilitated by the National Marrow Donor Program (NMDP) centers between 2006 and 2017. Examination of 7024 BM donors revealed that 60% received at least one unit of autologous blood. The donors who received autologous blood were older, had lower hemoglobin pre-harvest, underwent longer duration of anesthesia, and higher volume BM harvest. Only donors who underwent high-volume BM harvest, defined as a BM harvest volume >27% of donor's blood volume, benefited from autologous transfusion. After a high-volume BM harvest, autologous blood transfusion was shown to decrease grade 2 to 4 collection-associated toxicities within 48 h of BM donation (p = 0.010) and shorten the time to donor-reported "complete" recovery from donation-associated symptoms (p < 0.001). Therefore, autologous transfusion could be avoided as support of marrow donation in the majority of unrelated BM donors and should be limited to cases where the planned BM harvest volume is expected to exceed 27% of donor's blood volume.