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[Psychological issues of allogeneic bone marrow transplantation in adults]. SOINS; LA REVUE DE RÉFÉRENCE INFIRMIÈRE 2021; 66:43-45. [PMID: 33962732 DOI: 10.1016/s0038-0814(21)00100-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A bone marrow transplant is often the only hope for a cure for some patients with blood disease. Beyond its medical aspects, it underlies psychological issues for both the recipient and the donor. The transplant brings together the issues of donation, debt, the family romance and the incorporation of a "foreign body", evoking the classic notion of chimera.
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Polomeni A, Tardieu L, Ainaoui M, Andrianne C, Bancillon N, Chapel V, Chevallier N, Evrard S, Fournier I, Gargallo G, Godin S, Issarni D, Le Bars L, Renaud B, Yakoub-Agha I, Wallart A, De Bentzmann N. [Information booklet for related hematopoietic stem cell donors: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)]. Bull Cancer 2017; 104:S71-S75. [PMID: 29126585 DOI: 10.1016/j.bulcan.2017.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/03/2017] [Accepted: 08/09/2017] [Indexed: 10/18/2022]
Abstract
Providing information to living donors is first and foremost a legal obligation as well as an ethical one, not to mention necessary to health care provision. It's been shown that quality of information concerning the procedure's practical aspects, scheduling of clinical tests and examinations, withdrawing stem cells for the donation, post-donation symptoms, and support provided by healthcare teams, directly impacts the donor's quality of experience. Taking this into consideration our group decided it was essential to create an informational support for donors in the form of a booklet to be provided in different hematopoietic stem cell transplant centers across France. In September 2016 in Lille, France, the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) organized the 7th allergenic hematopoietic stem cell transplantation clinical practices harmonization workshops. As part of these workshops, our group worked collectively to develop a basis of indispensable information to be included in the booklet and presented using clear and accessible language.
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Affiliation(s)
- Alice Polomeni
- Assistance publique-Hôpitaux de Paris, hôpital Saint-Antoine, service d'hématologie et de thérapie cellulaire, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - Laure Tardieu
- Centre hospitalier Dupuytren, service d'hématologie, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - Malika Ainaoui
- CHRU de Lille, service des maladies du sang, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - Christelle Andrianne
- Centre hospitalier universitaire de Liège, domaine universitaire du Sart-Tilman, hématologie clinique, B35, 4000 Liège, Belgique
| | - Nelly Bancillon
- CHU d'Angers, service des maladies du sang, 49033 Angers cedex 2, France
| | - Valerie Chapel
- Centre hospitalier de Lyon Sud, hématologie secteur 1 G, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - Nathalie Chevallier
- CHRU de Strasbourg, unité de greffe de moelle osseuse, 1, avenue Molière, 67098 Strasbourg, France
| | - Solène Evrard
- CHU de Rennes, hématologie clinique, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - Isabelle Fournier
- CHRU hôpital Sud, service des maladies du sang, BP 3009, 80030 Amiens cedex, France
| | - Guillaume Gargallo
- G.H. du Haut-Levêque, service des maladies du sang, avenue de Magellan, 33604 Pessac, France
| | - Sandrine Godin
- CHRU de Lille, hôpital Jeanne-de-Flandre, service hématologie pédiatrique, avenue Eugen-Avinée, 59037 Lille, France
| | - Dominique Issarni
- Hôtel dieu CHU, service d'hématologie clinique, place Alexis-Ricordeaux, 44035 Nantes cedex 01, France
| | - Laetitia Le Bars
- CHU de Rennes, hématologie clinique, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - Barbara Renaud
- CHRU de Montpellier-site Saint-Éloi, département d'hématologie et de thérapie cellulaire, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - Ibrahim Yakoub-Agha
- CHU de Lille, LIRIC Inserm U995, université de Lille 2, 59000 Lille, France.
| | - Anne Wallart
- CHRU de Lille, service des maladies du sang, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
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Pahnke S, Larfors G, Axdorph-Nygell U, Fischer-Nielsen A, Haastrup E, Heldal D, Itälä-Remes M, Johansson JE, Kauppila M, Lenhoff S, Ljungman P, Niittyvuopio R, Sandstedt A, Hägglund H. Short-term side effects and attitudes towards second donation: A comparison of related and unrelated haematopoietic stem cell donors. J Clin Apher 2017; 33:226-235. [PMID: 28833474 DOI: 10.1002/jca.21576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/02/2017] [Accepted: 08/01/2017] [Indexed: 11/11/2022]
Abstract
The Nordic Register of Haematopoietic Stem Cell Donors (NRHSD) has registered related and unrelated donors from 10 transplant centres in Sweden, Norway, Finland and Denmark since 1998. We present a prospective, observational study of 1,957 donors, focusing mainly on the differences between related and unrelated donors. Related donors are reported to have more comorbidities, but similar side effects compared with unrelated donors. Side effects after BM or PBSC donation are generally of short duration and in this study no deaths, myocardial infarctions, splenic ruptures, or thromboembolic events are reported. Interestingly, related donors express more hesitancy towards donating again when asked 1 month after donation.
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Affiliation(s)
- Simon Pahnke
- Department of Haematology, Uppsala University Hospital, Uppsala, Sweden.,Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Gunnar Larfors
- Department of Haematology, Uppsala University Hospital, Uppsala, Sweden
| | - Ulla Axdorph-Nygell
- Centre for Apheresis and Stem Cell Processing (CASH), Clinical Immunology/Transfusion Medicine, and Department of Haematology, Karolinska University Hospital, Stockholm, Sweden
| | - Anne Fischer-Nielsen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eva Haastrup
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dag Heldal
- Department of Haematology, Oslo University Hospital, Oslo, Norway
| | - Maija Itälä-Remes
- Stem Cell Transplantation Unit, Turku University Hospital, Turku, Finland
| | - Jan-Erik Johansson
- Department of Haematology and Coagulation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marjut Kauppila
- Department of Haematology, Turku University Hospital, Turku, Finland
| | - Stig Lenhoff
- Department of Haematology, Skåne University Hospital, Lund, Sweden
| | - Per Ljungman
- Department of Haematology, Karolinska University Hospital, Division of Haematology, Karolinska Institutet, Stockholm, Sweden.,Department of Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Division of Haematology, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Huddinge, Karolinska University Hospital, Division of Haematology, Karolinska Institutet, Stockholm, Sweden
| | - Riita Niittyvuopio
- Stem Cell Transplantation Unit, Helsinki University Hospital, Helsinki, Finland
| | - Anna Sandstedt
- Department of Haematology, Linköping University Hospital, Linköping, Sweden
| | - Hans Hägglund
- Department of Haematology, Uppsala University Hospital, Uppsala, Sweden
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Polomeni A, Bompoint C, Gomez A, Brissot E, Ruggeri A, Belhocine R, Mohty M. Current practices for screening, consent and care of related donors in France: Haematopoietic stem cell transplantation coordinator nurses’ perceptions. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12612] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2016] [Indexed: 01/15/2023]
Affiliation(s)
- A. Polomeni
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - C. Bompoint
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - A. Gomez
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - E. Brissot
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - A. Ruggeri
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - R. Belhocine
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - M. Mohty
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
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Zhang Q, Xie C, Xie S, Liu Q. The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080816. [PMID: 27529264 PMCID: PMC4997502 DOI: 10.3390/ijerph13080816] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/05/2016] [Accepted: 08/08/2016] [Indexed: 11/25/2022]
Abstract
Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients’ quality at the end of life should be a concern. However, limited studies have been conducted locally to gather information about attitudes toward ADs. The purpose of this study was to investigate the attitudes of Chinese cancer patients and family caregivers toward ADs and to explore the predictors that are associated with attitudes. The study indicated that although there was low awareness of ADs, most cancer patients and family caregivers had positive attitudes toward ADs after related information was explained to them. Participants preferred to discuss ADs with medical staff when they were diagnosed with a life-threatening disease. Preferences for refusing life-sustaining treatment and choosing Hospice-Palliative Care (HPC) at the end of life would increase the likelihood of agreeing with ADs. This suggests that some effective interventions to help participants better understand end-of-life treatments are helpful in promoting ADs. Moreover, the development of HPC would contribute to Chinese cancer patients and family caregivers agreeing with ADs.
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Affiliation(s)
- Qiu Zhang
- Department of Health Service Management, Public Health School of Sun Yat-sen University, Guangzhou 510060, China.
| | - Chuanbo Xie
- State Key Laboratory of Oncology in South China, Department of Preventive Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
| | - Shanghang Xie
- State Key Laboratory of Oncology in South China, Department of Preventive Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
| | - Qing Liu
- State Key Laboratory of Oncology in South China, Department of Preventive Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
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The influence of the donor-recipient relationship on related donor reactions to stem cell donation. Bone Marrow Transplant 2014; 49:831-5. [PMID: 24637897 DOI: 10.1038/bmt.2014.38] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 01/23/2014] [Accepted: 01/29/2014] [Indexed: 11/08/2022]
Abstract
Previous research has begun to delineate the complicated reactions experienced by bone marrow and stem cell donors. The purpose of this study was to examine the influence of the donor-recipient relationship on the related donor's emotional reactions. Twenty-eight adult stem cell donors completed questionnaires before donation, 30 days post stem cell infusion, and 1 year after infusion. Questionnaires addressed the donor-recipient relationship, depression, mood, guilt and responsibility, self-esteem, ambivalence about donation and reactions to the donation itself. Results indicated that most donors reported little ambivalence about donation, and their reactions to the donation itself were generally positive. Closer and more positive donor-recipient relationships were associated with less anticipated guilt and responsibility if the transplant did not work. The relationships between the donor and the recipient did not change over time. Mood disturbance and depression were low overall, not related to the donor-recipient relationship, and did not significantly change over time. These results indicate that related stem cell donors are generally without significant emotional distress, and are comfortable with the donation process. Further, a more positive relationship with the recipient may help donors to avoid feeling guilty and responsible if the transplant does not work.
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Wallace J, Packman W, Huffman LC, Horn B, Cowan M, Amylon MD, Kahn C, Cordova M, Moses J. Psychosocial Changes Associated With Participation in Art Therapy Interventions for Siblings of Pediatric Hematopoietic Stem Cell Transplant Patients. ART THERAPY 2014. [DOI: 10.1080/07421656.2014.873685] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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A review of the haematopoietic stem cell donation experience: is there room for improvement? Bone Marrow Transplant 2014; 49:729-36. [DOI: 10.1038/bmt.2013.227] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 11/29/2013] [Accepted: 12/02/2013] [Indexed: 11/08/2022]
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Chan TK, Tipoe GL. The policy statement of the American Academy of Pediatrics -- children as hematopoietic stem cell donors -- a proposal of modifications for application in the UK. BMC Med Ethics 2013; 14:43. [PMID: 24176038 PMCID: PMC4228464 DOI: 10.1186/1472-6939-14-43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 09/18/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With a view to addressing the moral concerns about the use of donor siblings, the Policy Statement of the American Academy of Pediatrics - Children as Hematopoietic Stem Cell Donors (the Policy) has laid out the criteria upon which tissue harvest from a minor would be permissible. DISCUSSION Although tissue harvest serves the best interests of recipient siblings, parents are also obliged to act in the best interests of the donor sibling in the UK. Tissue harvest should proceed if and only if it serves the best interests of both the donor and recipient. Parents should be forbidden, and they are by UK law, to consent to tissue harvest unless there are substantial benefits for an incompetent minor that can outweigh the potential harm. There is no basis to subject a minor to the medical risks of tissue harvest if the recipient sibling can wait without significant risks of complications until the donor becomes Gillick competent. We also argue that the Policy fails to take into account recent advances in haematopoietic transplantation from haploidentical donors or related tissue-matched donors. SUMMARY Unless a recipient sibling will suffer from serious complications or die without the transplantation and no other medically equivalent donors are available, there is no moral or legal basis to violate the donor sibling's right to bodily integrity. Accordingly, we propose that the Policy should be modified in order to fully satisfy the legal requirements for application in the UK and other commonwealth jurisdictions with similar statute laws protecting minors.
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Affiliation(s)
- Tak Kwong Chan
- Anatomy, University of Hong Kong, L1-59, Laboratory Block, 21 Sassoon Road, Hong Kong, Hong Kong
| | - George Lim Tipoe
- Department of Anatomy, University of Hong Kong, L1-59, Laboratory Block, 21 Sassoon Road, Hong Kong, Hong Kong
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Garcia MC, Chapman JR, Shaw PJ, Gottlieb DJ, Ralph A, Craig JC, Tong A. Motivations, Experiences, and Perspectives of Bone Marrow and Peripheral Blood Stem Cell Donors: Thematic Synthesis of Qualitative Studies. Biol Blood Marrow Transplant 2013; 19:1046-58. [DOI: 10.1016/j.bbmt.2013.04.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 04/12/2013] [Indexed: 11/16/2022]
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11
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Hematopoietic stem cell donation. Int J Hematol 2013; 97:446-55. [DOI: 10.1007/s12185-013-1298-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
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12
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Pillay B, Lee SJ, Katona L, De Bono S, Warren N, Fletcher J, Burney S. The psychosocial impact of haematopoietic SCT on sibling donors. Bone Marrow Transplant 2012; 47:1361-5. [DOI: 10.1038/bmt.2012.22] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Oliveira-Cardoso ÉAD, Santos MAD, Mastropietro AP, Voltarelli JC. Bone Marrow Donation from the Perspective of Sibling Donors. Rev Lat Am Enfermagem 2010; 18:911-8. [DOI: 10.1590/s0104-11692010000500011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Accepted: 11/16/2009] [Indexed: 11/22/2022] Open
Abstract
This study aimed to characterize the sociodemographic profile of sibling bone marrow donors and to describe how they perceive the donation. This was a descriptive, exploratory and longitudinal study. Participants were 20 related bone marrow donors, between 18 and 42 years of age (mean=30.5 years, sd=7.47). Interviews were held before and immediately after the donation. Sociodemographic data were subject to descriptive statistical analysis and qualitative data to categorical content analysis. In the interviews held before the donation, stressor events were the sibling’s disease and treatment and the responsibility of being the donors. During the interviews after the donation, the following were mentioned: anxiety on the day before and on the day of the donation, pain the following day, and acknowledgement of the health team’s support as a facilitator of the donation process. In view of the findings, it is important for the team to outline intervention strategies to meet to the donors’ specific needs.
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O'Donnell PV, Pedersen TL, Confer DL, Rizzo JD, Pulsipher MA, Stroncek D, Leitman S, Anderlini P. Practice patterns for evaluation, consent, and care of related donors and recipients at hematopoietic cell transplantation centers in the United States. Blood 2010; 115:5097-101. [PMID: 20228276 PMCID: PMC2890146 DOI: 10.1182/blood-2010-01-262915] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 02/16/2010] [Indexed: 11/20/2022] Open
Abstract
Conflict of interest may arise when 1 physician serves 2 persons whose medical care is interdependent. In hematopoietic cell transplantation (HCT) from unrelated donors and in the setting of solid organ transplantation from living donors, the standard of care is for donors and recipients to be managed by separate physicians to provide unbiased care. However, the practice patterns of evaluation and care of related donors and recipients are not well described. A survey of HCT centers in the United States was conducted by the Donor Health and Safety Working Committee of the Center for International Blood and Marrow Transplant Research to determine the type of provider involved in medical clearance, informed consent, and medical management of hematopoietic cell collection and the relationship of that provider to the HC transplant recipient. The response rate was 40%. In greater than 70% of centers, transplantation physicians were involved or potentially involved in overlapping care of the HC transplant donor and the recipient. These patterns were similar between transplantation teams caring for adult or pediatric donors and recipients. Among responding centers, medical management of recipients and their related donors by the same provider is common, a practice that has the potential for conflict of interest.
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Wanner M, Bochert S, Schreyer IM, Rall G, Rutt C, Schmidt AH. Losing the genetic twin: donor grief after unsuccessful unrelated stem cell transplantation. BMC Health Serv Res 2009; 9:2. [PMID: 19128469 PMCID: PMC2630924 DOI: 10.1186/1472-6963-9-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 01/07/2009] [Indexed: 11/10/2022] Open
Abstract
Background Stem cell transplantations from related or unrelated donors are used to cure leukaemia and other blood diseases. When a patient dies after an unsuccessful transplantation, interested unrelated donors are informed about the failure by their donor centre. Studies focussing on failed related donations show that donors undergo an intense grieving process. As there are only two investigations about reactions from unrelated donors, knowledge about their reactions is less comprehensive. Methods We conducted a prospective study of reactions of unrelated donors to the information of failed transplantations, subject to various communication methods (letter, phone). Questionnaires were sent to 395 unrelated donors who received the news of their recipients' deaths between November 2005 and August 2006. In addition, twelve in-depth interviews with selected donors were carried out. Results Unrelated donors were emotionally affected by the recipients' deaths, and it is appropriate to speak about a "Donor Grief" phenomenon, as the results of 325 returned questionnaires (return rate 82.3%) and in-depth interviews show. Donors demonstrated a range of feelings such as sadness, disappointment, grief, and helplessness. These feelings were often unexpectedly intense given the fact that the recipient was a stranger. Although the news caused grief, donors underlined that they nevertheless wanted to be informed. They preferred knowledge of the failure to uncertainty. The method of providing the information is only of secondary importance. Most donors favoured the way of communication they had experienced. Conclusion This result indicates that both phone and letter communication can be justified. However, phone communication seems to be superior with respect to aspects of sensitivity. In spite of transplantation failure and the associated negative feelings, most donors were happy to have donated and would be willing to do so again. Our results underline the special responsibility of donor centres for informing and supporting unrelated volunteer donors in case their recipients have died.
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Affiliation(s)
- Martina Wanner
- DKMS German Bone Marrow Donor Center, Tuebingen, Germany.
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17
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Consulting clinic for related family donors in hematopoietic stem cell transplantation. Bone Marrow Transplant 2008; 41:1073-5. [PMID: 18332907 DOI: 10.1038/bmt.2008.42] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Oliveirao ÉAD, Santoso MAD, Mastropietro AP, Voltarelli JC. Repercussões psicológicas do transplante de medula óssea no doador relacionado. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2007. [DOI: 10.1590/s1414-98932007000300006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O desenvolvimento do transplante de medula óssea (TMO), nas últimas décadas, permitiu o tratamento de doenças que antes eram invariavelmente fatais. Dentre os tipos de transplante realizados, o alogênico exige a participação ativa de um membro familiar, em geral, o irmão, que arca com o encargo da doação. O objetivo do presente estudo é analisar as repercussões psicológicas dessa doação nos doadores relacionados. A amostra foi composta por dez doadores, vinculados à Unidade de TMO do HCFMRP-USP, avaliados antes e após a doação. Os instrumentos utilizados foram: roteiro de entrevista, escalas e técnicas projetivas. Os resultados demonstraram que o nível de ansiedade dos sujeitos se encontrava dentro do esperado, porém foram constatados sintomas de estresse. Afirmaram terem ficado ansiosos e relataram dor no momento pós-doação, mas acreditam que esta foi mais fácil do que imaginaram. Finalmente, em relação aos dados das técnicas projetivas, constatou-se uma alta suscetibilidade emocional, indícios de sugestionabilidade e dependência.
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Grupp SA, Frangoul H, Wall D, Pulsipher MA, Levine JE, Schultz KR. Use of G-CSF in matched sibling donor pediatric allogeneic transplantation: a consensus statement from the Children's Oncology Group (COG) Transplant Discipline Committee and Pediatric Blood and Marrow Transplant Consortium (PBMTC) Executive Committee. Pediatr Blood Cancer 2006; 46:414-21. [PMID: 16463346 DOI: 10.1002/pbc.20800] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Preliminary studies indicate that G-CSF-primed marrow harvesting may result in a graft with increased mononuclear cells collected, increased CD34(+) stem and progenitor cell dose and a potential for more rapid engraftment. Increased cell dose plus other potential positive effects of G-CSF priming have resulted in improved survival in non-randomized preliminary studies. These benefits may be available without the increased risk of chronic graft versus host disease (GVHD) that is experienced with allogeneic peripheral blood stem cell (PBSC) transplant. A phase III Children's Oncology Group (COG)/Pediatric Blood and Marrow Transplant Consortium (PBMTC) trial comparing G-CSF-primed marrow to standard marrow has been proposed. This document reviews background studies of G-CSF-primed marrow and addresses benefits and risks of G-CSF administration to normal pediatric donors. We conclude that the approach is promising and warrants further study. Risks of G-CSF to the donor are minimal and benefits to both donor and recipient may occur.
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Affiliation(s)
- Stephan A Grupp
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
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Kroschinsky F, Kittner T, Mauersberger S, Rautenberg U, Schuler U, Rutt C, Laniado M, Ehninger G. Pelvic magnetic resonance imaging after bone marrow harvest – a retrospective study in 50 unrelated marrow donors. Bone Marrow Transplant 2005; 35:667-73. [PMID: 15723083 DOI: 10.1038/sj.bmt.1704873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A total of 50 unrelated marrow donors were examined by pelvic magnetic resonance imaging (MRI) to investigate the morphological sequelae of bone marrow harvesting (BMH). Signal increase in T2-weighted sequences and contrast media enhancement in T1 sequences at the operative sites were found as typical MRI morphology 4 weeks after harvest (group A, n=16), corresponding to edema, hyperemia and proliferative activity. Although tissue repair was completed in the majority of donors 1 year after BMH, about 36% of donors in group B (n=16) had abnormal findings. These included a persistence of the 'acute injury' signal pattern (2/16, 12%), and signal alterations due to fatty marrow conversion (4/16, 24%). The proportion of MRI abnormalities increased to over 70% in two-time donors (group C, n=11), which might indicate a cumulation of tissue damage after repetitive harvests. If donors had experienced prolonged discomfort after BMH (group D, n=7), MRI revealed pathological signals in 86%. In conclusion, the MRI morphology reflects the pathophysiological reactions after BMH, including inflammation and tissue repair. A further prospective evaluation in a larger number of donors is necessary to confirm these results and to identify the factors which influence the extent and duration of tissue damage.
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Affiliation(s)
- F Kroschinsky
- University Hospital Dresden, 1st Medical Department, Dresden, Germany.
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Abstract
Abstract
Donation of hematopoietic stem cells, either through bone marrow or peripheral blood collection, is a generally safe procedure for healthy donors. Serious adverse events are uncommon and death is exceedingly rare. Nevertheless, all donors must be carefully evaluated and fully informed prior to donation. This should be done by clinicians having good understanding of the potential physical and psychological complications of donation and the factors that may increase these risks. Additionally, donors and graft products must be evaluated for the potential to transmit infections and other diseases to the recipient and to satisfy an increasing number of national and international regulatory requirements. Donors must be able to provide informed consent without coercion or pressure. Special attention to the clinical, psychological and social needs of pediatric donors is necessary.
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Affiliation(s)
- Mary M Horowitz
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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Chang G, McGarigle C, Koby D, Antin JH. Symptoms of pain and depression in related marrow donors: changes after transplant. PSYCHOSOMATICS 2003; 44:59-64. [PMID: 12515839 DOI: 10.1176/appi.psy.44.1.59] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Related or unrelated histocompatible marrow donors make it possible to offer hematopoietic stem cell transplants, the second most frequent solid organ transplant performed in the United States. About 20%-30% of donors are related to the recipient. Despite their importance, relatively little is known about related donors. The purpose of this prospective study is to describe changes in pain and depressive symptoms in 23 related marrow donors before and after marrow donation. Approximately 6 months after marrow donation, related marrow donors whose recipients died had significantly higher Beck Depression Inventory scores than did donors whose related recipients were living.
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Affiliation(s)
- Grace Chang
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA 02115, USA.
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Taïeb O, Dutray B, Pradère J, Moro MR. Enjeux psychiques du don de moelle osseuse. EVOLUTION PSYCHIATRIQUE 2002. [DOI: 10.1016/s0014-3855(02)00148-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Irving I, Cooper M, Durrant S. Sciatic nerve compression following bone marrow harvest. Bone Marrow Transplant 2000; 26:705-6. [PMID: 11041575 DOI: 10.1038/sj.bmt.1702585] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We describe a donor who suffered pain secondary to sacral plexus and sciatic nerve compression post bone marrow harvest. Haematoma was demonstrated by magnetic resonance image (MRI) scanning. To our knowledge, this is the first reported case of compression neuropathy post bone marrow harvest documented by MRI scanning. Given the increasing number of bone marrow transplants being performed and the paramount importance of donor safety, compressive neuropathies need to be remembered as rare but debilitating complications of bone marrow harvesting. MRI scanning is a useful modality to investigate severe or neuropathic pain post bone marrow harvest.
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Affiliation(s)
- I Irving
- Royal Brisbane Hospital, Herston, Queensland, Australia
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Holroyd E, Molassiotis A. Hong Kong Chinese perceptions of the experience of unrelated bone marrow donation. Soc Sci Med 2000; 51:29-40. [PMID: 10817466 DOI: 10.1016/s0277-9536(99)00427-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This paper presents a qualitative perspective of the Chinese experience of unrelated bone marrow donation. A total population of 37 Chinese men and women, residing in Hong Kong who had donated bone marrow to an unrelated recipient were interviewed and asked their retrospective perceptions and experiences during the process of unrelated bone marrow donation. The majority was female (60%) and single (59.3%). The median age was 30.9 years. The main themes drawn from thematic content analysis included: association with bad and good fortune, religious concerns associated with complete bodies, barriers posed by the extended family, fulfilling personal identities linked to perceptions of altruism, reciprocity and generosity and the differences between the expectations and reality of the experience of bone marrow donation. These accounts indicate how, for Chinese populations, the act of body fluid donation cannot be isolated from the experiences of life-long immersion in the dominant social and cultural processes of the time. In addition, Confucian notions of the body, the power of body fluids to pollute, the importance of blood and bones as sources of vital energy and the process of bodily transference into the after life are highlighted. Furthermore, what is also identifiably Chinese is that donation is more of a self-fulfilling act than a social act with very little familial or social recognition being accorded in the public world. The conclusion highlights how donors entered into the decision to donate with little awareness of the long-term consequences. The process, however, was seen by the donors to be beneficial. A compelling argument is made for more educational and emotional support regarding the experience of bone marrow donation from Hong Kong's formal service providers.
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Affiliation(s)
- E Holroyd
- Department of Nursing, The Chinese University of Hong Kong, Shatin, New Territories.
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