Ethical considerations of using a single minor donor for three bone marrow harvests for three HLA-matched siblings with primary immunodeficiency. Pediatr Blood Cancer 2019 Apr;66(4):e27602
Date
01/05/2019Pubmed ID
30609294DOI
10.1002/pbc.27602Scopus ID
2-s2.0-85059550768 (requires institutional sign-in at Scopus site) 1 CitationAbstract
Allogeneic hematopoietic stem cell transplantation is curative for primary immunodeficiencies. Bone marrow from an unaffected human leukocyte antigen (HLA)-identical sibling donor is the ideal graft source. For minor donors, meaningful consent or assent may not be feasible, and permission from parents or legal guardians is considered acceptable. Adverse events, albeit extremely small, can be associated with bone marrow harvest in pediatric donors. Donor safety concerns potentially increase with multiple bone marrow harvests. Very little is known about multiple bone marrow harvests from pediatric donors. We describe the ethical considerations and clinical decision-making in an unusual clinical situation where three patients with the same primary immunodeficiency were HLA identical to one another and their younger sibling, who underwent bone marrow harvests three times between 1.3 and 4 years of age, resulting in successful transplantation for all three patients. We hope that this experience will provide guidance to providers and families in a similar situation.
Author List
Parikh SH, Pentz RD, Haight A, Adeli M, Martin PL, Driscoll TA, Page K, Kurtzberg J, Prasad VK, Barfield RCAuthor
Kristin Page MD, MHS, MEd Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Bioethical IssuesBone Marrow Transplantation
Child, Preschool
Female
Hematopoietic Stem Cell Transplantation
Humans
Immunologic Deficiency Syndromes
Infant
Male
Siblings
Tissue Donors
