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Long-term follow-up of cancer and catastrophic diseases in hematopoietic stem cell donors: a comprehensive matched cohort study

Bone Marrow Transplantation (2024)Cite this article

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Abstract

Hematopoietic stem cell (HSC) transplantation, using either bone marrow (BM) or peripheral blood stem cells (PBSC), is a well-established therapy for various hematologic and non-hematologic diseases. However, the long-term health outcomes after HSC donation remain a major concern for several potential donors. Thus, we aimed to conduct a matched cohort study of 5003 unrelated donors (1099 BM and 3904 PBSC) and randomly selected 50,030 matched controls based on age, sex, and resident area from the donor registry between 1998 and 2018. The medical insurance claims of all the participants were retrieved from the Taiwan National Health and Welfare Data Science Center after de-identification. Our findings revealed no differences in the incidence of cancer, death, and catastrophic diseases between HSC donors and matched healthy participants during long-term follow-up. Kaplan–Meier curves depicting the cumulative incidence of cancer and overall mortality throughout the follow-up period also demonstrated similar outcomes between donors and non-donors. In conclusion, our results indicate that HSC donation, whether through BM or PBSC, is safe and not associated with an increased risk of cancer, death, or catastrophic diseases. These findings provide valuable information for counseling potential HSC donors and for long-term management of HSC donor health.

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Fig. 1
Fig. 2: The cumulative incidiences of major outcomes.

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Data availability

The datasets generated during the current study are not publicly available because all analyses were performed within the HWDC, and no individual data could be released. Only the summarized outcomes were used for this article.

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Acknowledgements

We thank Health and Welfare Data Science Center, Ministry of Health, and Welfare (HWDC, MOHW) for supplying the data.

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Author notes

  1. These authors contributed equally: Sung-Chao Chu, Chia-Jung Hsieh.

Authors and Affiliations

  1. Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

    Sung-Chao Chu, Chi-Cheng Li, Yi-Feng Wu & Tso-Fu Wang

  2. Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan

    Sung-Chao Chu, Chi-Cheng Li, Shang-Hsien Yang, Szu-Chin Li, Woei-Yau Kao, Dian-Kun Li, Yi-Feng Wu, Ruey-Ho Kao & Tso-Fu Wang

  3. Department of Public Health, College of Medicine, Tzu-Chi University, Hualien, Taiwan

    Chia-Jung Hsieh

  4. Buddhist Tzu-Chi Stem Cells Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

    Chi-Cheng Li, Shang-Hsien Yang, Kuo‐Liang Yang & Tso-Fu Wang

  5. Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

    Shang-Hsien Yang

  6. Department of Hematology and Oncology, Dalin Tzu-Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan

    Szu-Chin Li

  7. Department of Hematology and Oncology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan

    Woei-Yau Kao

  8. Department of Hematology and Oncology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan

    Dian-Kun Li & Ruey-Ho Kao

  9. School of Medicine, National Tsing Hua University, Hsinchu, Taiwan

    Ruey-Ho Kao

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Contributions

SCC and TFW conceived and designed the study. CJH performed the statistical analysis. SCC, CCL, SHY, and TFW reviewed and interpreted data. CJH and TFW wrote the manuscript with input from all coauthors. SCC, CJH, CCL, SHY, SCL, WYK, DKL, YFW, RHK, KLY and TFW contributed the study conduct, provided critical feedback, and revised the manuscript. SCC and CJH contributed equally as co-first authors.

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Correspondence to Tso-Fu Wang.

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Chu, SC., Hsieh, CJ., Li, CC. et al. Long-term follow-up of cancer and catastrophic diseases in hematopoietic stem cell donors: a comprehensive matched cohort study. Bone Marrow Transplant (2024). https://doi.org/10.1038/s41409-024-02204-7

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