Pertinence du prélèvement sanguin autologue et de sa transfusion lors d’un don de moelle osseuse

Abstract

We assessed the benefit of predeposite autologous blood donation (PAD) before bone marrow (BM) donation on transfusion requirements, haemoglobin concentrations (Hb) and the occurrence of adverse events (AE). We collected data retrospectively from 50 donors of BM with PAD from 2010 to 2014. An autologous transfusion (AT) was given to 50% of the donors (group 1). In the group 2, the products from PAD were not used. The total volume median of marrow harvested was 17.7mL/k (range 12.3–21.4) in the group 1 and 13.3mL/k (8.6–22.6) in the group 2. The female ratio was higher in the group 1 (60%) than in the group 2 (16%). Bone marrow harvest led to a decline in Hb (from PAD to first day after BM donation) by 2.9g/dL (1.5–5.5) in the group 1 and by 3.5g/dL (1.2–5) in the group 2. The post-harvest Hb (D+1) median was identical in the two groups: 10.9g/dL (7.6–13.5) in the group 1 versus 11.5g/dL (9.3–13.4) in the group 2. Six AE were reported in each group. In the group with AE, the median weight was lower: 58 k (50–71) versus 75 k (52–110); and the median total volume of marrow harvested was higher: 20.1mL/k (9.9–21.4) versus 14.3mL/k (8.6–22.6). All post-harvest Hb were ≥ 7.6g/dL. This study shows the high loss of Hb after BM donation but not enough to prove a blood transfusion in BM donors with median age of 36 years (16–62) and without comorbidity. The occurrence of AE (25% of BM donors) justifies a careful surveillance after the BM donation. The PAD should not be routinely offered to bone marrow donors.