Polomeni A, Bompoint C, Labopin M, Badoglio M, Battipaglia G, Eeltink C, Liptrott S J, Babik A, Murray J, Stringer J
Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France.
EBMT Nurses Group, Department of Hematology and Cell therapy, Saint Eloi Hospital, Montpellier, France.
Bone Marrow Transplant. 2020 Mar;55(3):623-632. doi: 10.1038/s41409-019-0686-y. Epub 2019 Oct 2.
Allogeneic haematopoietic cell transplantation (HCT) is a curative procedure for patients with haematological malignancies and immune deficiencies. A human leukocyte antigen (HLA) identical sibling is only available for 25-35% of patients in need. The improvement in haplo-identical transplantation has led to a marked increase in cell donation from relatives. Despite international recommendations, discrepancies in related-donors (RD) care exist between centres, particularly regarding medical suitability criteria, consenting procedures and donor follow-up. This European survey aimed to explore hematopoietic cell transplantation coordinators nurses' (HCT-CNs) perceptions of RD care, in particular the association with the presence or not of an independent unit (IU). Ninety-three HCT-CNs from seventy-six EBMT centres responded, representing 19 countries (response rate: 27%). Our results did not show a significant association between IU and HCT-CNs perceptions of related-donors care. The practices for RD care vary among centres regarding presence or not of an IU (48%), person caring for RD (haematologist in 54%, HCT physician in 17%, HCT-CNs in 20%), person to whom the results of HLA typing are communicated, use of a booklet for RD, follow-up or not and periodicity of follow-up. Qualitative data highlight the related-donation ethical issues and the need for improvement in RD care. HCT-CNs' main concerns were: the necessary confidentiality to insure the voluntary status of RD, the perceived conflict of interest felt by professionals when managing both patients and RD, plus the psychosocial aspects of related-donation. Even if there is a variety of a practice among centres, the presence of an IU is not significantly associated with an improvement in RD care.
异基因造血细胞移植（HCT）是治疗血液系统恶性肿瘤和免疫缺陷患者的一种治愈性方法。只有25%-35%有需求的患者能获得人类白细胞抗原（HLA）匹配的同胞供者。单倍体相合移植技术的改进使得亲属供者的细胞捐献显著增加。尽管有国际推荐，但各中心在亲属供者（RD）护理方面存在差异，尤其是在医学适用性标准、知情同意程序和供者随访方面。这项欧洲调查旨在探讨造血细胞移植协调护士（HCT-CNs）对RD护理的看法，特别是与独立单元（IU）的有无之间的关联。来自76个欧洲血液与骨髓移植协会（EBMT）中心的93名HCT-CNs做出了回应，代表19个国家（回复率：27%）。我们的结果未显示IU与HCT-CNs对亲属供者护理的看法之间存在显著关联。关于IU的有无（48%）、负责RD护理的人员（血液科医生占54%，HCT医生占17%，HCT-CNs占20%）、HLA分型结果告知对象、是否使用RD手册、是否进行随访以及随访周期等方面，各中心对RD护理的做法各不相同。定性数据突出了亲属捐献的伦理问题以及RD护理改进的必要性。HCT-CNs主要关注的问题包括：确保RD自愿状态所需的保密性、专业人员在管理患者和RD时所感受到的利益冲突，以及亲属捐献的社会心理方面。即使各中心的做法存在差异，但IU的存在与RD护理的改善并无显著关联。
