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Psychosocial outcomes of parents in pediatric haploidentical transplant: parental hematopoietic cell donation as a double-edged sword

Bone Marrow Transplantation volume 57, pages 377–383 (2022)Cite this article

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Abstract

Parents are increasingly used as donors for their child’s haploidentical hematopoietic cell transplant, creating a dual role for parents that may increase the stress of caring for their ill child. Empiric research on the psychological adjustment of parental donors is lacking. We conducted a retrospective survey of parents (n = 136) whose child underwent transplant with a parental donor or a matched-unrelated donor, including both donor and nondonors, and both parents of survivors and bereaved. All parents completed standardized measures of quality of life, depression, anxiety, post-traumatic stress, and life satisfaction. Bereaved parents also completed measures of their grief response, while parents of survivors completed measures of the parent–child relationship. The overall sample reported psychological functioning near normative levels, but bereaved parents demonstrated significantly poorer outcomes across all measures. The effect of donor status differed by transplant outcome: for parents of survivors, donors reported better mental health than nondonors, but amongst bereaved parents, donors fared more poorly than nondonors. Bereaved donors reported greater difficulties with grief than nondonors. Results suggest that serving as donor can be a double-edged sword, acting as a protective factor when there is a successful outcome but a significant risk factor when the child does not survive.

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Fig. 1: Results of 2 (survivors/bereaved) × 2 (donor/nondonor) analysis of covariance on study outcomes.
Fig. 2: Differences between donor and nondonor bereaved parents on grief symptoms.

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Funding

This study is supported in part by the National Institutes of Health Cancer Center Support Grant, P30 21765, and by the American Lebanese-Syrian Associated Charities (ALSAC).

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Authors and Affiliations

  1. Department of Psychology, St. Jude Children’s Research Hospital Memphis, Memphis, TN, USA

    Vanessa Aguilera, Megan R. Schaefer, Kendra Parris, Alanna Long & Sean Phipps

  2. Department of Bone Marrow Transplantation & Cellular Therapy, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Brandon Triplett

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Contributions

VA: data analysis, interpretation, and lead manuscript writing; MRS and KP: data analysis, interpretation, and manuscript review and editing; AL: data collection, data analysis and interpretation, and manuscript review and editing; BT: study design and manuscript review and editing; SP: study design, data collection, analysis, interpretation, and manuscript review and editing; and all authors: reviewed and approved submission of the manuscript in its final form.

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Correspondence to Sean Phipps.

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Aguilera, V., Schaefer, M.R., Parris, K. et al. Psychosocial outcomes of parents in pediatric haploidentical transplant: parental hematopoietic cell donation as a double-edged sword. Bone Marrow Transplant 57, 377–383 (2022). https://doi.org/10.1038/s41409-021-01547-9

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