Peripheral Blood Stem Cell Donation Risks

It's most common now that people donate peripheral blood stem cells (PBSCs) for transplant, though in some cases people still donate bone marrow. If you are considering donating bone marrow instead of PBSCs check out the possible risks of donating bone marrow.

Peripheral Blood Stem Cell Collection

To understand the potential risks of donating stem cells, it can help to first review the process of how stem cells are collected for transplant. Beginning 4 or 5 days before the procedure you will be given injections to increase the number of stem cells in your blood. The procedure itself takes place through an IV placed in your arm or a central line into a larger blood vessel. Your blood is collected, filtered to remove stem cells, the passed back into your body.

Potential Risks

There are a few separate risks to consider in a peripheral blood stem cell donation. 

The first has to do with the medications you receive during the days prior to the procedure. A medication referred to as granulocyte colony-stimulating factor (Neupogen) is usually given daily for 4 or 5 days by injection, in order to increase the number of stem cells present in your blood. Side effects of this medication often include bone pain, as well as the risk of an allergic reaction. At one time it was thought that granulocyte stimulating factor may increase the risk of leukemia in those who received it, but that does not appear to be the case, and in one large study the incidence of leukemia in people who had received granulocyte stimulating factor in preparation for donating stem cells was actually lower than the average in the population.

The second potential risk has to do with the blood draw itself. Sometimes in order to place the IV, a central line needs to be placed in a larger vein in your body. This carries the risk of bleeding as well as the rare risk of puncturing one of your lungs. Since your blood (minus stem cells) is returned to your body, you will not have many of the symptoms people associate with donating blood.

While your blood is being filtered (a process called apheresis) you may feel a bit light-headed. You may also have chills, cramps in your hands, and a feeling of numbness around your lips. This is temporary and does not persist for longer than a few hours after the collection procedure is done.

Mild Risks and Side Effects

The most bothersome side effects of a stem cell donation usually occur in the days before the donation and are related to the side effects of the injections of granulocyte stimulating factor. These include bone pain and body aches.

There may be some discomfort with the inserting the IV, as well as chills and hand cramps as noted above.

Severe Risks and Side Effects

Serious adverse events are quite rare with stem cell donation. In a review of donations by the National Marrow Donor Program, less than 1% of donors suffered a serious adverse event.

Around the world, one study looked at over 23,000 people who had donated peripheral blood stem cells. Among these people, there were 4 fatalities and 25 serious adverse events (mostly heart-related), but the study included programs around the world with much less stringent requirements for donors that those in the United States.

Donor and Patients

If you are considering donating stem cells to someone outside of your family, you may wonder if you will have a chance to talk with the recipient of your cells. There are strict confidentiality procedures concerning this, but it can be heartwarming to read stories of donors and patients who have had the chance to meet.

Making Your Decision

Overall, donating peripheral blood stems cells is a very safe procedure, with the potential to be lifesaving in its goal. If you are considering donating, take time to weigh the risks and benefits, and decide what is best for you.