| Summary: | 碩士 === 中國醫藥大學 === 醫務管理學系碩士班 === 102 === Objective: In recent years, the use of allogeneic hematopoietic stem cell (HSC) transplantation is increased. The past literature revealed that granulocyte colony-stimulating factor (G-CSF) increased the risk of cancer. However, peripheral blood stem cell donor needed to receive the G-CSF during donation. By now, in Taiwan, no study confirmed that peripheral blood stem cell collection increased the risk of cancer after G-CSF mobilization was used in healthy allogeneic donors. The aim of this study was to evaluate allogeneic hematopoietic stem cell donors in risk of cancer and examined the relevant factors of cancer in Taiwan.
Methods: This study was a retrospective cohort study. The National Health Insurance Research Database of Taiwan between 1999 and 2010 was used. The study subjects included 451 bone marrow stem cell donors (BMSCs) and 756 peripheral blood stem cell donors (PBSCs). After a ratio of 1:10 propensity score matching, a total of 13277 subjects were included in the study. We conducted the Cox proportional hazards model to examine the incidence risk of cancer on hematopoietic stem cell donors and relevant factors.
Results: Incidence risk of cancer in bone marrow stem cell donors (0.56 per 1000 person-years) was significantly lower (p <0.05) than that of the public (1.27 per 1000 person-years); incidence risk of cancer in peripheral blood stem cell donors (0.75 per 1000 person-years) was significantly lower (p <0.05) than that of the public (2.15 per 1000 person-years). The cancer risk was lower in bone marrow stem cell donors than that of general population, but there was no significant difference (HR = 0.49; 95% CI :0.12-2 .01, p> 0.05); peripheral blood stem cell donors also had lower risk of cancer compared with the general population, and it also had no significant difference (HR = 0.33; 95% CI :0.08-1 .365, p> 0.05). There was insignificant difference of the cancer risk in bone marrow and peripheral blood stem cell donors groups (HR = 1.91,95% CI :0.14-26 .41). Age, gender, environmental condition and income were not relevant factors with incidence of cancer (p> 0.05).
Conclusions: This study showed that incidences of cancer among allogeneic HSC donors were lower than that of general population. The risk of cancer in peripheral blood stem cell donors was not higher than that of bone marrow stem cell donors.
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