Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2018
Higher Risks of Toxicity and Incomplete Recovery in 13- to 17-Year-Old Females after Marrow Donation: RDSafe Peds Results.
СтатьяМногоцентровое исследованиеПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАПоддержка правительства СШАПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Pulsipher Michael A, Logan Brent R, Kiefer Deidre M, Chitphakdithai Pintip, Riches Marcie L, Rizzo J Douglas, Anderlini Paolo, Leitman Susan F, Varni James W, Kobusingye Hati, Besser RaeAnne M, Miller John P, Drexler Rebecca J, Abdel-Mageed Aly, Ahmed Ibrahim A, Ball Edward D, Bolwell Brian J, Bunin Nancy J, Cheerva Alexandra, Delgado David C, Dvorak Christopher C, Gillio Alfred P, Hahn Theresa E, Hale Gregory A, Haight Ann E, Hayes-Lattin Brandon M, Kasow Kimberly A, Linenberger Michael, Magalhaes-Silverman Margarida, Mori Shahram, Prasad Vinod K, Quigg Troy C, Sahdev Indira, Schriber Jeffrey R, Shenoy Shalini, Tse William T, Yanik Gregory A, Navarro Willis H, Horowitz Mary M, Confer Dennis L, Shaw Bronwen E, Switzer Galen E
Аннотация
Although donation of bone marrow (BM) or peripheral blood stem cells (PBSCs) from children to family members undergoing allogeneic transplantation are well-established procedures, studies detailing levels of pain, symptoms, and long-term recovery are lacking. To address this lack, we prospectively enrolled 294 donors age <18 years at 25 pediatric transplantation centers in North America, assessing them predonation, peridonation, and at 1 month, 6 months, and 1 year postdonation. We noted that 71% of children reported pain and 59% reported other symptoms peridonation, with resolution to 14% and 12% at 1 month postdonation. Both older age (age 13 to 17 years versus younger) and female sex were associated with higher levels of pain peridonation, with the highest rates in older females (57% with grade 2-4 pain and 17% with grade 3-4 pain). Multivariate analyses showed a 4-fold increase in risk for older females compared with males age <13 years (P <.001). At 1 year, 11% of 13- to 17-year-old females reported grade 2-4 pain, compared with 3% of males age 13 to 17 years, 0% of females age <13 years, and 1% of males age <13 years (P = .01). Males and females age 13 to 17 years failed to return to predonation pain levels at 1 year 22% and 23% of the time, respectively, compared with 3% and 10% in males and females age <13 years (P = .002). Our data show that females age 13 to 17 years are at increased risk of grade 2-4 pain at 1 year and >20% of females and males age 13 to 17 years do not return to baseline pain levels by 1 year after BM donation. Studies aimed at decreasing symptoms and improving recovery in older children are warranted.