Health-Related Quality of Life Among Older Adult Related Hematopoietic Stem Cells (HSC) Donors (>60 yrs.) Is Equivalent to or Better Than That of Younger Adult Related Donors (18-60 yrs.)

It is critical to understand HRQoL among older related siblings who are increasingly asked to donate HSC.  Findings presented here are from a 5 year study of related donor (RD) safety and HRQoL (RDSafe).  The goal was to compare HRQoL in older vs. younger adult RD.

           

Participants were older adult RD (ages >60 yrs; median=65 yrs; n=105) and younger adult RD (ages 18-60; median=42 yrs; n=59) who donated PBSC at domestic U.S. centers between 3/2010 and 4/2013.  Data were collected via structured telephone interviews at pre-donation, and 4 weeks and 1 year post-donation.  Interviews focused on socio-demographics, physical and mental health, and donation-related perceptions using well-validated instruments including the SF-12v2 to assess general physical/mental health.  Odds-ratios for dichotomous variables t-tests for continuous variables and mixed linear models were used to examine age group differences. 

Demographics: Older RD were less likely to be employed, and more likely be white, married, and to have children.  Pre-donation: Pre-donation, older RD had poorer physical health (t=-3.28; p<.01) but did not differ from younger RD on psychosocial variables including general mental health, depression, and anxiety.  There were no group differences in ambivalence, satisfaction, or medical concerns about donation although older RD were more likely to consult their physician about donation (OR=13.18; p<.001).  Older RD had fewer work/family concerns (t=-2.04; p<.05).  Post-donation: 4 weeks post-donation, there were no group differences in general physical health, mental health, or any of 12 donation-related symptoms.  Older RD were less likely to report donation-related pain (t=-2.29; p<.05) and continued to have fewer work/family concerns about the donation process (t=-3.39; p<.01).  At 1 year post-donation, there were no differences in general physical and mental health or in the percent of RD reporting feeling completely back to normal.  There was a nonsignificant trend for older RD to report a longer recovery period (t=1.78; p=.08).  Older RD reported fewer current problems sleeping (OR=0.39; p<.05) but did not differ from younger RD on any other symptoms or in concern about longer-term donation effects.  Mixed linear models (Figure 1) indicated that older RD had poorer physical health (primarily pre-donation) but better mental health.  There was no main effect difference by data collection time point and no age by time interaction for physical or mental health.

Despite having somewhat poorer overall general pre-donation health, older RD experience similar – and in some domains better – donation-related HRQoL compared to younger RD.  This is a reassuring finding that supports the use of older family members as donors and will further inform the counseling and consent of older RD.