Individual at risk
Donor
Guidance at RECRUITMENT for adult volunteer donor (NA for maternal donor (cord blood donation))
ACCEPTABLE. It is very unlikely that a donor who is pregnant at recruitment will be called to donate within the first year of joining the register.
Guidance at CT/WORK-UP
QUALIFIED, see below
Guidance
Unacceptable
Currently pregnant;
Less than one week has passed for every completed week of a recent pregnancy
Less than three months have passed since a first trimester
The pregnancy resulted in a malignant hydatidiform mole
The pregnancy resulted in a non-malignant hydatidiform mole and treatment and follow-up is ongoing
Breastfeeding
Breast-feeding mothers may donate by either method, providing the above criteria have been met regarding pregnancy.
For donors donating by PBSC, it is recommended that mothers who wish to continue breast-feeding after donation should should not feed their infant (but may express and discard milk) from the point of first G-CSF administration to one week following the last dose of G-CSF.
For donors donating by BM, it is recommended that mothers who wish to continue breast-feeding after donation should not feed their infant (but may express and discard milk) from the point of administration of any sedating agent to 24 hours following the last dose of sedating anaesthetic or opiate analgesia.
Justification for guidance
Both G-CSF and use of general anaesthesia may present a higher risk of adverse events in the pregnant female. In addition, the safety of G-CSF in pregnancy or during breast-feeding has not been established.
References
Kaida K, Ikegame K, Fujioka T, Taniguchi Y, Inoue T, Hasei H, et al. Kinetics of granulocyte colony-stimulating factor in the human milk of a nursing donor receiving treatment for mobilization of the peripheral blood stem cells. Acta Haematol 2007;118(3):176-7.