The ethics and risks of expecting teen siblings to be transplant donors

A sibling may often be the best match for a patient who needs a stem cell transplant, but especially for adolescent donors, who are at a vulnerable age, factors such as the responsibility to donate versus a perception of free choice and the potential for anxiety and guilt in the face of complications or poor outcomes demand careful consideration. The benefits, burdens, and risks of adolescent sibling stem cell donation are discussed in an article in Journal of Adolescent and Young Adult Oncology (JAYAO).

In "Matched Marrow, Sibling Shadow: The Epidemiology, Experience, and Ethics of Sibling Donors of Stem Cells", Meaghann Weaver, MD, MPH, Ashley Carr, CCLS, and Brandon Triplett, MD, St. Jude Children's Research Hospital (Memphis, TN) and Douglas Diekema, MD, MPH, Seattle, Children's Research Institute, WA, focus on a range of issues unique to adolescents with siblings that require a hematopoietic stem cell transplant. Along with familial expectations, and positive feelings of altruism and self-worth, the scenario may include health risks, pain, and psychological burdens.

"The role of the sibling in providing life sustaining stem cells has for too long been taken for granted," says Editor-in-Chief Leonard S. Sender, MD, University of California, Irvine and CHOC Children's Hospital, Orange, CA. "This paper highlights some of the issues and challenges the AYA community to rethink the role of the sibling in all the complex interplays that occur in the cancer patient/family relationships."