Donation of peripheral blood stem cells to unrelated strangers: A thematic analysis

Annelies Billen, J Alejandro Madrigal, Katrina Scior, Bronwen E Shaw, Andre Strydom, Annelies Billen, J Alejandro Madrigal, Katrina Scior, Bronwen E Shaw, Andre Strydom

Abstract

Background: Donation of haematopoietic stem cells, either through bone marrow (BM) or peripheral blood stem cell (PBSC) collection, is a generally safe procedure for healthy donors, although side effects are a known risk. Previous research, including our recent quantitative study, has shown that the psychosocial response to donating is usually a positive one and most donors would be willing to donate again in the future. This is often despite experiencing significant side effects during the donation process. Due to the relative recent introduction of PBSC, a comprehensive understanding of the range of physical and emotional issues donors may experience is lacking, as well as an understanding of specific donor characteristics Qualitative research can provide rich narrative data into these areas. This study was set up in order to identify specific donor characteristics and to further explore the relationship between pre-donation physical health and the donation experience, as previously identified in our quantitative study.

Methods: It involved in-depth telephone interviews with 14 PBSC donors who participated in our original quantitative study. Thematic analysis was used to analyse the findings and the results provide a summary of participants' characteristics using themes and constituent codes.

Results: We identified several donor characteristics, including strong intrinsic motivation, altruism, sense of duty, determination, low levels of ambivalence and the ability to develop a strong emotional relationship with an (unknown/anonymous) recipient whilst being able to manage strong feelings and emotions.

Conclusions: These personality traits may explain the resilience that has been observed previously in haematopoietic stem cells donors. Significant feelings of grief were reported after a recipient's death. Possibilities to alleviate these symptoms may include raising awareness of potential poor outcomes in the recipient and offering improved counselling services if the recipient dies. We acknowledge several limitations including the sampling frame.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Anasetti C, Logan BR, Lee SJ, Waller EK, Weisdorf DJ, Wingard JR et al. Peripheral blood stem cells versus bone marrow from unrelated donors. N. Engl J Med. 2012; 367: 1487–96. doi:
    1. Hatzimichael A and Tuthill M. Hematopoietic stem cell transplantation. Stem cells cloning 2010;3:105–117. doi:
    1. Pamphilon D, Nacheva E, Navarrete C, Madrigal A and Goldman J. The use of granulocyte-colony-stimulating factor in volunteer unrelated hemopoietic stem cell donors. Transfusion. 2008;48:1495–501. doi:
    1. de la Rubia J, de Arriba F, Arbona C, Pascual MJ, Zamora C, Insunza A, et al. Follow-up of healthy donors receiving granulocyte colony-stimulating factor for peripheral blood progenitor cell mobilization and collection. Results of the Spanish Donor Registry. Haematologica. 2008;93(5):735–40. doi:
    1. Holig K, Kramer M, Kroschinsky F, Bornhauser M, Mengling T, Schmidt AH, et al. Safety and efficacy of hematopoietic stem cell collection from mobilized peripheral blood in unrelated volunteers: 12 years of single-center experience in 3928 donors. Blood. 2009;114(18):3757–63. doi:
    1. Miller JP, Perry EH, Price TH, Bolan CD Jr., Karanes C, Boyd TM, et al. Recovery and safety profiles of marrow and PBSC donors: experience of the National Marrow Donor Program. Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation. 2008;14(9 Suppl):29–36.
    1. Siddiq S, Pamphilon D, Brunskill S, Doree C, Hyde C, Stanworth S. Bone marrow harvest versus peripheral stem cell collection for haemopoietic stem cell donation in healthy donors. The Cochrane database of systematic reviews. 2009(1):Cd006406 doi:
    1. Pulsipher MA, Chitphakdithai P, Miller JP, Logan BR, King RJ, Rizzo JD, et al. Adverse events among 2408 unrelated donors of peripheral blood stem cells: results of a prospective trial from the National Marrow Donor Program. Blood. 2009;113(15):3604–11. doi:
    1. Pulsipher MA, Chitphakdithai P, Logan BR, Shaw BE, Wingard JR, Lazarus HM, et al. Acute toxicities of unrelated bone marrow versus peripheral blood stem cell donation: results of a prospective trial from the National Marrow Donor Program. Blood. 2013;121(1):197–206. doi:
    1. Butterworth VA, Simmons RG, Bartsch G, Randall B, Schimmel M, Stroncek DF. Psychosocial effects of unrelated bone marrow donation: experiences of the National Marrow Donor Program. Blood. 1993;81(7):1947–59.
    1. Christopher KA. The experience of donating bone marrow to a relative. Oncol Nurs Forum. 2000;27(4):693–700.
    1. Simmons RG, Schimmel M, Butterworth VA. The self-image of unrelated bone marrow donors. J Health Soc Behav. 1993;34(4):285–301.
    1. Billen A, Madrigal JA, Strydom A, Szydlo RM, Switzer GE, Shaw BE. Predonation health-related quality of life scores predict time to recovery in hematopoietic stem cell donors. Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation. 2015;21(2):350–6.
    1. Ware JE, Jr., Kosinski M., Bjorner J.B. et al. SF-36v2 Health Survey: Administration Guide for Clinical Trial Investigators QualityMetric, Incorporated. 2008.
    1. Switzer GE, Bruce JG, Harrington D, Haagenson M, Drexler R, Foley A, et al. Health-related quality of life of bone marrow versus peripheral blood stem cell donors: a prespecified subgroup analysis from a phase III RCT-BMTCTN protocol 0201. Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation. 2014;20(1):118–27.
    1. Bredeson C, Leger C, Couban S, Simpson D, Huebsch L, Walker I, et al. An evaluation of the donor experience in the canadian multicenter randomized trial of bone marrow versus peripheral blood allografting. Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation. 2004;10(6):405–14.
    1. Holroyd E, Molassiotis A. Hong Kong Chinese perceptions of the experience of unrelated bone marrow donation. Social science & medicine (1982). 2000;51(1):29–40.
    1. Stroncek DF, Holland PV, Bartch G, Bixby T, Simmons RG, Antin JH, et al. Experiences of the first 493 unrelated marrow donors in the National Marrow Donor Program. Blood. 1993;81(7):1940–6.
    1. Switzer GE, Dew MA, Butterworth VA, Simmons RG, Schimmel M. Understanding donors' motivations: a study of unrelated bone marrow donors. Social science & medicine (1982). 1997;45(1):137–47.
    1. Pillay B, Lee SJ, Katona L, De Bono S, Warren N, Fletcher J, et al. The psychosocial impact of haematopoietic SCT on sibling donors. Bone marrow transplantation. 2012;47(10):1361–5. doi:
    1. Garcia MC, Chapman JR, Shaw PJ, Gottlieb DJ, Ralph A, Craig JC, et al. Motivations, experiences, and perspectives of bone marrow and peripheral blood stem cell donors: thematic synthesis of qualitative studies. Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation. 2013;19(7):1046–58.
    1. Bryman A. Social research methods Oxford: Oxford University Press; 2001.
    1. Braun V and Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77–101.
    1. Switzer GE, Goycoolea JM, Dew MA, Graeff EC and Hegland J. Donating stimulated peripheral blood stem cells vs bone marrow: do donors experience the procecures differently? Bone Marrow Transplant 2001;27:917–23. doi:
    1. Heldal D, Brinch L, Tjonnfjord G, Solheim BG, Egeland T, Gadeholt G et al. Donation of stem cells from blood or bone marrow: results of a randomised study of safety and complaints. Bone Marrow Transplant 2002;29:479–86. doi:
    1. Switzer GE, Simmons RG, Dew MA. Helping Unrelated Strangers: Physical and Psychological Reactions to the Bone Marrow Donation Process Among Anonymous Donors1. J Appl Soc Psychol. 1996;26(6):469–90.
    1. Switzer GE, Myaskovsky L, Goycoolea JM, Dew MA, Confer DL, King R. Factors associated with ambivalence about bone marrow donation among newly recruited unrelated potential donors. Transplantation. 2003;75(9):1517–23. doi:
    1. 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 doi:
    1. Atkinson M. Communicating news of patients' deaths to unrelated stem cell donors. Nurs Stand. 2005;19(32):41–7. doi:
    1. Butterworth VA, Simmons RG, Schimmel M. When altruism fails: reactions of unrelated bone marrow donors when the recipient dies. Omega. 1992;26(3):161–73.
    1. Goldman JM. A special report: bone marrow transplants using volunteer donors—recommendations and requirements for a standardized practice throughout the world—1994 update. The WMDA Executive Committee. Blood. 1994;84(9):2833–9.
    1. Jäckle A, Roberts C and Lynn P. Telephone versus Face-toFace Interviewing: Mode Effects on Data Quality and Likely Causes. Report on Phase II of the ESS-Gallup Mixed Mode Methodology Project, ISER Working Paper 2006–41. Colchester: University of Essex.
    1. Switzer GE, Dew MA, Harrington DJ, Crowley-Matoka M, Myaskovsky L, Abress L, et al. Ethnic differences in donation-related characteristics among potential hematopoietic stem cell donors. Transplantation. 2005;80(7):890–6.
    1. Switzer GE, Bruce JG, Myaskovsky L, DiMartini A, Shellmer D, Confer DL, et al. Race and ethnicity in decisions about unrelated hematopoietic stem cell donation. Blood. 2013;121(8):1469–76. doi:

Source: PubMed

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