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Predeposit autologous blood donation (PAD) is frequently offered to bone marrow donors, but its cost-effectiveness is dubious. We assessed the impact of PAD and bone marrow donation on transfusion requirements; and the use of donated blood units in a retrospective study of 61 bone marrow donors. The mean haemoglobin (Hb) concentration fell from 12·9 to 11·8 g dL−1 in women who predonated one unit and from 13·2 to 10·9 g dL−1 in those who predonated two units. In men who donated two units of blood, the Hb concentration decreased to 12·9 g dL−1. Bone marrow harvest led to a further decline in Hb concentration by 2·3 g dL−1 in women and by 2·4 g dL−1 in men. The postharvest Hb fell to ≤9·0 g dL−1 in 39% of female and in 6% of the male donors; all but one of them had predonated blood. The utilization rate of autologous units was 45·6%, with 55% of women and 24% of men receiving autologous blood. In females, 59% of transfused autologous units were given with the donor's Hb of ≥ 9·0 g dL−1; overtransfusion was even more apparent in men: 71% units were given with a Hb ≥ 10·0 g dL−1. PAD in bone marrow donors is associated with high wastage and increases the likelihood of requiring a transfusion. We recommend that PAD should not be routinely offered to bone marrow donors. [ABSTRACT FROM AUTHOR]