Research Article

The motivational factors and adverse events experienced by healthy volunteers donating bone marrow for research

Mirella Ejiugwo, Georgina Shaw, Frank Barry, Janusz Krawczyk and Veronica McInerney*

Published: 05 December, 2019 | Volume 2 - Issue 1 | Pages: 089-096

Background: With the advancement of cell therapy research, there is an increasing need for healthy volunteers (HV) to donate small volumes (30 ml) of human bone marrow (BM). The BM procedure required to procure small volumes is invasive, although short-lived (25 seconds), is not without risk. To ensure a sustainable supply of BM for research and cell therapy, greater information of the risks and factors that motivate HV to donate small volumes of BM will help optimize the procedure and HV enrolment, ensuring donors are fully informed of the potential risks.

Objective: To identify the adverse events (AE) experienced by HV during and after small volume BM procedure and understand the motivating factors that influence HV to donate BM for research.

Method: HV (n = 55) who donated BM (30 ml) for scientific research and provided informed consent were administered a questionnaire to identify the type, duration and severity of AE experienced during and post-BM aspiration; and to determine the motivating factors that influenced their willingness to donate BM.

Results: Pain was experienced by 89% of participants during the BM procedure with moderate grade reported by 40%. One/more of the following AE were experienced by 73% of the volunteers post-BM procedure: pain, fatigue, site reaction, nausea and transient hypotension. AE resolved within an average of three days. The reported motivational factors ranked in the following order: first, to advance research for the benefit of future patients; compensation for participation; free medical check-up; lastly, the research question was interesting.

Conclusion: Young HV, motivated primarily by altruism and financial compensation, risk the occurrence of transient AE following donation of small-volume BM for research.

Read Full Article HTML DOI: 10.29328/journal.ijbmr.1001010 Cite this Article Read Full Article PDF


Bone marrow donation; Mesenchymal stromal cell research; Motivational factors for bone marrow donation; Healthy volunteers; Adverse events


  1. Gratwohl A, Niederwieser D. History of hematopoietic stem cell transplantation: evolution and perspectives. Curr Probl Dermatol. 2012; 43: 81-90. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22377922
  2. Zakirova EY, Valeeva AN, Aimaletdinov AM, Nefedovskaya LV, Akhmetshin RF, et al. Potential therapeutic application of mesenchymal stem cells in ophthalmology. Exp Eye Res. 2019; 189: 107863. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31669045
  3. Patel DM, Shah J, Srivastava AS. Therapeutic potential of mesenchymal stem cells in regenerative medicine. Stem Cells Int. 2013; 2013: 496218. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23577036
  4. Kassem M, Kristiansen M, Abdallah BM. Mesenchymal stem cells: cell biology and potential use in therapy. Basic Clin Pharmacol Toxicol. 2004; 95: 209-214. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15546474
  5. Gandini A, Roata C, Franchini M, Agostini E, Guizzardi E, et al. Unrelated allogeneic bone marrow donation: short- and long-term follow-up of 103 consecutive volunteer donors. Bone Marrow Transplant. 2001; 28: 369-374. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11571509
  6. Buckner CD, Clift RA, Sanders JE, Stewart P, Bensinger WI, et al. Marrow harvesting from normal donors. Blood. 1984; 64: 630-634. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6380620
  7. Piccin A. Do we need to test blood donors for sickle cell anaemia? Blood Transfus. 2010; 8: 137-138. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20671871
  8. Chen SH, Wang TF, Yang KL. Hematopoietic stem cell donation. Int J Hematol. 2013; 97: 446-455. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23420184
  9. Pulsipher MA, Chitphakdithai P, Logan BR, Shaw BE, Wingard JR, et al. Acute toxicities of unrelated bone marrow versus peripheral blood stem cell donation: results of a prospective trial from the National Marrow Donor Program. Blood. 2013; 121: 197-206. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23109243
  10. Sakamaki H, Takamoto S, Shibata H. Complications of marrow harvesting for transplantation. Rinsho Ketsueki. 1994; 35: 29-35.
  11. Horowitz MM, Confer DL. Evaluation of Hematopoietic Stem Cell Donors. Hematology Am Soc Hematol Educ Program. 2005; 2005: 469-475. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16304422
  12. Bosi A, Bartolozzi B. Safety of bone marrow stem cell donation: a review. Transplant Proc. 2010; 42: 2192-2194. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20692441
  13. Miller JP, Perry EH, Price TH, Bolan CD Jr, Karanes C, et al. Recovery and safety profiles of marrow and PBSC donors: experience of the National Marrow Donor Program. Biol Blood Marrow Transplant. 2008; 14: 29-36. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18721778
  14. Lisenko K, Stadtherr P, Bruckner T, Pavel P, Heilig CE, et al. Bone Marrow Harvesting of Allogeneic Donors in an Outpatient Setting: A Single-Center Experience. Biol Blood Marrow Transplant. 2016; 22: 470-474. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26551634
  15. Stroncek DF, Holland PV, Bartch G, Bixby T, Simmons RG, et al. Experiences of the first 493 unrelated marrow donors in the National Marrow Donor Program. Blood. 1993; 81: 1940-1946. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8461478
  16. Butterworth VA, Simmons RG, Bartsch G, Randall B, Schimmel M, et al. Psychosocial effects of unrelated bone marrow donation: experiences of the National Marrow Donor Program. Blood. 1993; 81: 1947-1959. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8461479
  17. Siddiq S, Pamphilon D, Brunskill S, Doree C, Hyde C, et al. Bone marrow harvest versus peripheral stem cell collection for haemopoietic stem cell donation in healthy donors. Cochrane Database Syst Rev. 2009; 1. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19160282
  18. Favre G, Beksac M, Bacigalupo A, Ruutu T, Nagler A, et al. Differences between graft product and donor side effects following bone marrow or stem cell donation. Bone Marrow Transplant. 2003; 32: 873-880. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/14561987
  19. Nishimori M, Yamada Y, Hoshi K, Akiyama Y, Hoshi Y, et al. Health-related quality of life of unrelated bone marrow donors in Japan. Blood. 2002; 99: 1995-2001. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11877271
  20. Switzer GE, Bruce JG, Harrington D, Haagenson M, Drexler R, et al. Health-related quality of life of bone marrow versus peripheral blood stem cell donors: a prespecified subgroup analysis from a phase III RCT-BMTCTN protocol 0201. Biol Blood Marrow Transplant. 2014; 20: 118-127. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24184336
  21. Shaw BE, Logan BR, Kiefer DM, Chitphakdithai P, Pedersen TL, et al. An Analysis of the Effect of Race, Socioeconomic Status and Center Size on Unrelated NMDP Donor Outcomes: Donor Toxicities are More Common at Low Volume Bone Marrow Collection Centers. Biol Blood Marrow Transplant. 2015; 21: 1830-1838. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26116089
  22. Switzer GE, Dew MA, Butterworth VA, Simmons RG, Schimmel M. Understanding donors' motivations: a study of unrelated bone marrow donors. Soc Sci Med. 1997; 45: 137-147. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9203278
  23. Briggs NC, Piliavin JA, Lorentzen D, Becker GA. On willingness to be a bone marrow donor. Transfusion. 1986; 26: 324-330. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/3523872
  24. Garcia MC, Chapman JR, Shaw PJ, Gottlieb DJ, Ralph A, et al. Motivations, Experiences, and Perspectives of Bone Marrow and Peripheral Blood Stem Cell Donors: Thematic Synthesis of Qualitative Studies. Biol Blood Marrow Transplant. 2013; 19: 1046-1058. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23603456
  25. Soule MC, Beale EE, Suarez L, Beach SR, Mastromauro CA, et al. Understanding Motivations to Participate in an Observational Research Study: Why do Patients Enroll? Soc Work Health Care. 2016; 55: 231-246. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26933943
  26. Squillaro T, Peluso G, Galderisi U. Clinical Trials with Mesenchymal Stem Cells: An Update. Cell Transplant. 2016; 25: 829-848. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26423725
  27. Sjostrom O, Holst D. Validity of a questionnaire survey: response patterns in different subgroups and the effect of social desirability. Acta Odontol Scand. 2002; 60: 136-140. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12166905
  28. Tishler CL, Bartholomae S. The Recruitment of Normal Healthy Volunteers: A Review of The Literature on the Use of Financial Incentives. J Clin Pharmacol. 2002; 42: 365-375. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11936560
  29. Grady C. Payment of clinical research subjects. J Clin Invest. 2005; 115: 1681-1687. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16007244
  30. Stunkel L, Grady C. More than the money: a review of the literature examining healthy volunteer motivations. Contemp Clin Trials. 2011; 32: 342-352. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21146635
  31. Boo M, van Walraven SM, Chapman J, Lindberg B, Schmidt AH, et al. Remuneration of hematopoietic stem cell donors: principles and perspective of the World Marrow Donor Association. Blood. 2011; 117: 21-25. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20921337
  32. Jean JE. Effects of accurate expectations about sensations on the sensory and distress components of pain. J Pers Soc Psychol. 1973; 27: 261-275. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/4723974
  33. Suls J, Wan CK. Effects of sensory and procedural information on coping with stressful medical procedures and pain: A meta-analysis. J Consult Clin Psychol. 1989; 57: 372-379. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2738210
  34. Pamphilon D, Siddiq S, Brunskill S, Dorée C, Hyde C, et al. Stem Cell Donation –What advice can be given to the donor? Br J Haematol. 2009; 147: 71-76.
  35. Kelley K, Clark B, Brown V, Sitzia J. Good practice in the conduct and reporting of survey research. Int J Qual Health Care. 2003; 15: 261-266. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12803354


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