Perception of Matched Sibling Hematopoietic Stem Cell Donor about Donation of Stem Cells

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is the curative treatment option for a variety of hematological disorders. Usually, stem cells for HSCT are obtained from matched related donors through bone marrow harvest or apheresis. Although stem cell donation is relatively a safe procedure, there are many psychosocial concerns among potential donors regarding the donation of stem cells and its possible complications. The present study aims to understand the experience of being a hematopoietic stem cell donor for a sick sibling. Eighty hematopoietic stem cell sibling donors were interviewed with a self-structured questionnaire comprising of 3 domains-intrinsic and extrinsic motivators and deterrents. Data were analyzed using descriptive and inferential statistics using IBM SPSS® Statistics version 20.0. The present study found that nearly half of them (47.5%) were <30 years of age with 52.5% being male, 57.5% were married and 53.8% were employed. 43.8% were graduates of which 7.5% had a family income of <Rs.5,000. 51.2% hailed from rural backgrounds. The majority of them (90%) of them had no co-morbidities. All of them underwent local anesthesia and had peripheral stem cells as the source of harvest. None of them had a previous history of stem cell donation. The majority of the matched sibling donors were primarily influenced by intrinsic factors (median score-3.2). The influence of the deterrents is lesser than the influence of the motivators (median score-1). There is a statistically significant association between gender and the influence of extrinsic motivators (P = 0.024), marital status and deterrents (P = 0.003), and age and deterrents (P = 0.019) in the hematopoietic stem cell donation process. Among the deterring facets, the emotional concern of being responsible for the outcome of the transplant was the major barrier (45%). The family concern of taking up the burden of being a donor and a family member is the least deterring facet (62.5%). Among the intrinsic motivating facets, positive feelings (87.5%) and family loyalty (81.3%) were the major motivating factors whereas reinvesting back into the community was the least intrinsically motivating factor (32.5%). Among the extrinsic motivating facets, complete awareness of the donation process through explanation was the highly motivating factor (93.8%). Family pressure/social obligation was the least extrinsically motivating facet (83.8%). The study highlights the role of intrinsic motivation in the stem cell donation process and warrants for further exploration.