Important Dates &
Upcoming Meetings

 

For details of related meetings, a regularly updated list of all meetings and conferences taking place can be found here.

 

30 March- 2 April 2008
EBMT Annual Congress
Click here

 

  • 1-6 March, 2008
    Sofia, Bulgaria
    2nd ESO Masterclass in Oncology Nursing (European School of Oncology)
    Click here
  • 5-9 March, 2008
    Antalya, Turkey
    5th National Bone Marrow & Stem Cell Therapies Congress

    Included in the programme will be a joint certification course and examination with EBMT-NG called 1st Stem Cell Transplantation Nurse Certification Programme.

    Topics covered will be: Venous Access, Chemotherapy Administration, GVHD Care and Mucositis."
    Click here
  • 27-29 March, 2008
    Geneva, Switzerland
    6th EONS Spring Convention (European Oncology Nursing Society)
    Click here

    •  

  • 30 March- 2 April 2008
    EBMT Annual Congress, Florence, Italy
    34th Annual Meeting of the European Group for Blood and Marrow Transplantation
     
    24th Meeting of the EBMT Nurses Group
     
    7th Meeting of the EBMT Data Management Group
     
    2nd EBMT Patient & Family Day
    Click here
  • April 1, 2008
    EBMT NG Exchange Visit & Education Scolarship Deadline
    Applications for scholarships should be submitted to Erik Aerts
    Further information
    Click here
  • June 2-4, 2008
    Poznan, Poland
    6th Meeting of the EBMT Paediatric Disease Working Party

    1st Meeting of the EBMT Paediatric Nurses
    Click here
  • June 4-7, 2008
    Lugano, Switzerland
    10th International Conference on Malignant Lymphoma
    Click here
  • June 15 -19, 2008
    Ljubljana, Slovenia
    17th WCET Congress (World Council of Enterostomal Therapists)
    Click here
  • August 17-21, 2008
    Singapore
    15th ISNCC International Conference (International Society of Nurses in Cancer Care)

    Early registration deadline is 29th February, 2008
    Click here

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Donor Issues Article

Managing An Ethical Challenge: A Call For Guidelines For The Management Of Related Donors Of Haematopoietic Stem Cells.

L Ritchie(1) and B Jones(2), on behalf of the EBMT (UK) NAP group(3)

  1. 1-Nurse Practitioner Haemato-oncology, The Royal Marsden NHS Foundation Trust Hospital, Sutton, UK
    2-Associate Specialist, Transfusion Medicine, National Blood Service, Sheffield, UK
    3-EBMT (UK) Nurses and Allied Professional Group

 

Background: There is an increasing demand for allogeneic haematopoietic stem cell transplant (HSCT) donors.  EBMT registry data shows that 10 504 allogeneic HSCTs were performed in Europe in 2006.  This number continues to increase at an annual rate of 5 to 10%.

Allogeneic stem cell donors are either related to the recipient or unrelated volunteer registry donors.  There is a 25% chance that a patient’s sibling will be HLA-matched, alternatively a search is initiated through the unrelated donor registries (Atkinson 2005). 

The ‘International standards for cellular therapy product collection, processing and administration’ (FACT-JACIE 2007) requires that each HSCT centre have written criteria for the donation of haematopoietic stem cells (HSCs).  This is to protect the safety of donors throughout the donation process and to ensure the quality of HSCs for recipients.  These standards make no distinction between related and unrelated donors. 

A standardized approach to donor care is well established in the unrelated setting and the World Marrow Donor Association (WMDA) provides a forum for mutual discussion on all issues regarding the clinical use of HSCs from unrelated donors across international boundaries. Discussions take place in working groups, making it possible to formulate guidelines on for example logistics, quality control, accreditation, ethics and information technology.  In addition, the WMDA has adopted standards and an accreditation process; both of which are aimed at enhancing the quality of the international search and procurement process (Hurley and Raffoux 2004). 

In contrast, there are no guidelines or forums concerned with the distinct issues regarding the procurement of HSCs from related donors.  Interest appeared to be building when the EBMT nurses’ research sub-group launched a European survey of current practice regarding informed consent and psychological issues for the related donor at an annual meeting (Prague 2005).  The results of this survey did not, however, lead to guidelines on best practice. 

The influences on related donor care, the ethical issues faced and the need for related donor guidelines were discussed at the 32nd EBMT (UK) NAP group meeting held in Birmingham on 9 November 2007.

Influences on related donor care

Influences on related donor care are not restricted to regulatory policy.  The recent suggestion of an association between short course granulocyte-colony stimulating factor (G-CSF) and lymphocyte genetic abnormalities and possible malignancy has had a further impact on peripheral blood stem cell donor care (Nagler et al 2004, Bennett et al 2006).  Although this view has been challenged (Goldman et al 2006) additional recommendations now include: 

  • Transplant centres and donor registries should ensure that they follow normal donors post donation with greater stringency. The duration of follow-up should arguably be a minimum of 10 years and perhaps lifelong. Such follow-up should apply equally to bone marrow donors.
  • Donors should be studied longitudinally with cytogenetic analyses of lymphocytes and other tests designed to detect persisting damage both to the lymphoid and to the myeloid lineage.
  • Donors should be exposed to minimum amounts of haematopoietic growth factors.
  • Consideration should be given to long-term (more than 1 year) insurance cover of donors following leucaphaeresis.
  • Donors must be told of the somewhat uncertain situation regarding G-CSF for blood stem cell mobilization so that they can balance the risks against those associated with bone marrow donation. The possibility of G-CSF associated malignancy should be discussed with each donor and statements included about it in the informed consent.

Implementing these additional recommendations may be particularly challenging in the related HSCT donor setting where family dynamics already provide unique pressures during donor work-up and follow-up.  Some issues include: 

 

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