Acute Toxicities of Bone Marrow Donation in Unrelated Donors with Sickle Cell Trait: A Center for International Blood and Marrow Transplantation Research Analysis.

Ethnic minority donors are essential in international donor registries to ensure access to all patients requiring allogeneic stem cell transplantation. Current literature regarding bone marrow (BM) donation-associated pain and toxicity in donors with sickle cell trait (ST), a condition that disproportionally affects minorities, is very limited. Improved communication with potential donors with ST about donation-associated toxicities is important to address misconceptions about donation and may increase the likelihood of participation by minority donors. The aim of this study was to determine the impact of ST on pericollection pain and toxicities experienced by unrelated BM donors. The study population comprised first-time unrelated donors with ST and a subset of unrelated donors without ST from the United States whose BM donation was facilitated by the National Marrow Donor Program (NMDP) between 2010 and 2019. Donors in the control group (ie, donors without ST) were selected for propensity score matching based on age categories, sex, race/ethnicity, and predonation skeletal pain. Logistic regression models were conducted to compare the donors with and without ST for pain and toxicities associated with donation after adjusting for differences in donor characteristics. Descriptive statistics were used to report serious adverse events. Univariate probabilities of complete recovery from donation were calculated using the Kaplan-Meier estimator. A total of 346 BM donors (87 with ST and 259 without ST) were included in this study. The majority of the donors in both cohorts were male (52%), African American (64%) and overweight or obese (77%). Stem cell collection parameters, including BM harvest volume, requirement for autologous blood transfusion postharvest, and duration of anesthesia were comparable between the 2 cohorts. At 2 days postdonation, 68.9% of BM donors with ST and 83.1% of BM donors without ST experienced skeletal pain (P < .01). Although grade 1 pain was more common in donors without ST (51.4% vs 35.6%), grade 2-4 pain was comparable between the 2 cohorts (P = .98). At 1 month postdonation, the incidence of grade 2-4 pain was also comparable between the 2 cohorts (P = .25). By 6 months postdonation, the rates of persistent pain were low, at 5.7% in donors with ST and 6.5% in donors without ST. Donation-related modified toxicity criteria (MTC) at 2 days postdonation were comparable between the 2 cohorts (P = .59). The median time to recovery was 23.5 days in donors with ST and 22.0 days in donors without ST. The rate of reported AEs was slightly higher in donors with ST (2.29% versus 1.59%). BM donation appeared to be well tolerated in donors with ST, with similar rates of postdonation pain and general symptoms as seen in donors without ST. Moreover, BM donation carries a low risk of perioperative mortality, comparable to that observed in donors without ST. This report provides, to our knowledge, the first comprehensive analysis of the impact of ST on toxicities and recovery after BM donation and adds to our understanding of the safety of BM donation in donors with ST.