Healthy sibling donor anxiety and pain during bone marrow or peripheral blood stem cell harvesting for allogeneic transplantation: results of a randomised study

Abstract

Summary:This study reports the first comparison of healthy donor subjective well-being during two alternative procedures of hematopoietic stem cells harvesting for allogeneic transplantation. Among the 105 donors included between September 1996 and October 1998 in the SFGM French randomised trial aiming to compare allogeneic bone marrow (BM) transplantation and blood cell (BC) transplantation, 64 donors (33 in BC and 31 in BM groups) were relevant for the analysis. They had received a set of self-administered questionnaires to complete during the collection process, aiming to measure anxiety (assessed using the Spielberger's State-Trait Anxiety Inventory) and pain induced by the procedure (evaluated using a visual analogical scale). Results showed that no harvest procedure is free from pain even if none was more painful than the other. Levels of anxiety before the collection procedure were high in both groups and significantly so for BC donors. Although BC collection induces at least similar levels of pain and anxiety as does BM collection, they were of a different kind, and the short-term impact of G-CSF stimulation on the well-being of BC donors has to be taken into account in improving quality of care in the allogeneic setting. Bone Marrow Transplantation (2002) 29, 145-149. DOI: 10.1038/sj/bmt/1703338 Keywords: healthy donors; hematopoietic stem cell harvest; anxiety; pain; allogeneic transplantation Blood cell transplantation (BCT) is now the standard for autologous transplant: 1 the main arguments in favour of substituting this procedure for classical bone marrow transplantation (BMT) in the autologous setting were quicker haematological recovery, decrease in related cost 2,3 and easier progenitor collection associated with an increased

Potential adult sibling stem cell donors’ perceptions and opinions regarding an information and care model

“…Takita et al 16 , in a case report, described the stress experienced by a sibling who was not HLA matched with her ill sister. Earlier studies have shown that sibling stem cell donors are in a vulnerable situation, [3][4][5][6]12,13,17,18 and the survey findings indicate that this is also true of siblings who are unable to donate. A suggestion is that all HLA typed potential sibling donors should receive the typing results through personal contact with health professionals, and that they should receive it before the patient.…”

Bone Marrow Donation from the Perspective of Sibling Donors

“…A previous study (9) had already demonstrated that the depreciation of the quality of life and physical health of the recipient causes an adverse impact on the life of the related donor. It is confirmed, therefore, that the physical conditions of the recipient are associated with the emotional reactions to the donor (4) .In relation to the experience of donating bone marrow, where literature is still very restricted, it is perceived that the act of donating brings diverse psychological implications for donors: before the donation in the form of anxiety (10)(11) , immediately after the process, due to the influence of psychological factors and years elapsed, as changes arising in the quality ofThere is a shortage of studies dedicated to evaluating the experience and subjective implications of donating bone marrow for the related donor. This study aims to reduce this gap.…”

Having a sibling as donor: Patients' experiences immediately before allogeneic hematopoietic stem cell transplantation

“…Earlier studies have shown that sibling donors are in a vulnerable situation (Bredeson et al, 2004;Fortanier et al, 2002;Wiener et al, 2008;Williams et al, 2003), and Study II indicates that this is true even for siblings who are unable to donate. This has also been shown in a case study (Takita et al, 2011) describing the stress experienced by a sibling who did not HLA match her ill sister.…”

“…The harvesting takes place at the surgery theatre and usually the donor stays in hospital for 2-3 days. The most common and transient side-effects of bone marrow harvesting are fatigue, lower back pain and pain at the site where the needles were inserted, and nausea from the sedation (Fortanier et al, 2002;Switzer et al, 2001).…”

“…The common side effects from these injections are headache, muscle pain and bone pain (Fortanier et al, 2002;Kennedy et al, 2003;Switzer et al, 2001). The stem cells are then collected, using apheresis technology, from the peripheral blood, usually via one needle placed in a vein in one arm.…”