PERIPHERAL BLOOD STEM CELL DONATION AWARENESS AMONG COLLEGE STUDENTS Ms.Sruthy.T.Varghese 1, Mrs. Moly Hem 2 1 II Year MSc Nursing, Amrita College of Nursing, AIMS, Kochi, (India) 2 Associate Professor, Department of Medical Surgical Nursing, Amrita College of Nursing, Kochi, (India) ABSTRACT A critical shortage exists for donors of peripheral blood stem cells (PBSC). College and graduate students have become a key focus for marrow donor registration as they are young, healthy, well educated, more open to new information, and part of a community. A descriptive study was conducted to assess knowledge of peripheral blood stem cell donation among 81 participants from Albertian institute of science and technology, Ernakulam, Kerala. Majority of students (81.5%) were not aware about PBSC donation. There was a significant association between knowledge on stem cell donation and information received about PBSC (p<0.05).findings regarding the assessment of knowledge of college students revealed that out of 81 subjects, 56 (69.1%) were having inadequate knowledge, 25 (30.9%) having moderately adequate knowledge and none of them have adequate knowledge regarding PBSC with the mean score of 9.63 and standard deviation ± 2.477.College and graduate students are easily accessible and important group to target. Educational interventions focusing on this target group can increase PBSC registration and have the potential to improve patient outcomes thus save lives. Health promotion must be focused to non-health science institutes along with community health and awareness for a healthy future so as to promote healthy living Keywords: Awareness, College Students, Knowledge, Peripheral Blood Stem Cell Donation I. INTRODUCTION Peripheral bloodor Hematopoietic stem cell is widely considered as the key technology to the effective treatments for various life-threatening diseases of the blood and immune system and certain inherited metabolic diseases. There are three ways to get hematopoietic stem cell; from umbilical cord blood, bone marrow, and peripheral blood. Umbilical cord blood makes it easy to find the stem cell that matches the human leucocyte antigen (HLA) type and less likely to cause complication such as Graft-Versus-Host-Disease (GVHD), while its lack of enough concentrated nucleated cells restricts adult implantation and it can be sampled only during the labour. The global use of bone marrow has been decreasing as people are wary of donation and the procedure causes discomfort and pain. However, the peripheral blood has been continuously gaining more popularity.[1] Stem cell transplants are used to replace bone marrow that isn t working or has been destroyed by disease, chemotherapy, or radiation (treatment for cancer). In some diseases, like leukemia, aplastic anemia, certain inherited blood diseases, and some diseases of the immune system, the stem cells in the bone marrow may not work the way they should. Any of these problems can cause the body to not have enough normal red blood cells, white blood cells, or platelets. A stem cell transplant may help correct these problems. [2] 1 P a g e
In some cancers, such as certain leukemias, multiple myeloma, and some lymphomas, a stem cell transplant can be an important part of treatment. It works like this: high doses of chemotherapy, which is sometimes given with radiation, work better than standard doses to kill cancer cells. But high doses can also cause the bone marrow to completely stop making blood cells. This is where stem cell transplants come in. The transplanted cells replace the body s source of blood cells after the bone marrow and its stem cells have been destroyed by the treatment. This transplant lets doctors use much higher doses of chemotherapy to try to kill all of the cancer cells. Donated cells can often find and kill cancer cells better than the immune cells of the person who had the cancer ever could. This is called the graft-versuscancer or graft-versus-leukemia effect. It means that certain kinds of transplants actually help fight the cancer cells, rather than simply replacing the blood cells.[2] PBSC donation is simple and safe. The donor most preferably must be aged 18-50. It is found that younger donors are the most likely to be chosen as donors by the transplant physicians. They present fewer medical risks and as they can stay on the donor registry for longer. First the donor has to register in a PBSC registry. Then give a Buccal Swab sample. Buccal swabbing is an effective, quick, and painless DNA sample collection technique. When a possible match is found the donor will receive Neupogen injections for 5 days leading up to the day of donation. This is done to enable the blood forming cells to be released into the blood. PBSC donation procedure is done in a blood centre or hospital outpatient clinic. There is no requirement of hospitalization. Afterwards the donor will be able to leave hospital soon after donating. The donor will be able to go back to normal activities the same day, in most cases. PBSC donation is done through a process called apheresis, which is similar to donating plasma or platelets. During apheresis, a needle will be placed into each arm. Blood will be led from a vein in one arm through tubing into a blood cell separator machine. The machine collects only the blood-forming cells, and other components like plasma are returned to the donors body through the other arm. Some Donors may experience mild aches or discomfort, similar to a cold or flu. Simple paracetamol is generally adequate to manage the discomfort. Less than one percentage of donors may experience allergic reaction to Neupogen, which may include skin rashes or shortness of breath. During donation, some donors experience tingling around the mouth, fingers and toes and mild muscle cramps. Slowing down the procedure or giving the donor calcium easily treats these symptoms. In India Stem cell treatment can help more than 120,000 people diagnosed with blood cancers, most of them being children and another 10,000 children born with Thalassemia. Thus there is increased demand for PBSC donors nationally. [3] A critical shortage exists for donors of peripheral blood stem cells. Each day, between 6,000 and 7,000 individuals nationally in Rhode island suffering with leukemia, lymphoma and other blood disorders search for a potential match. As few as 30% are able to find a match within their own family; the remaining 70% depend on national or international registries to find potential donors to treat these deadly diseases. The more the people need to get hematopoietic stem cell transplantation, the more registration is needed. Therefore providing proper information is very important to encourage hematopoietic stem cell donation registration.[1, 4] Recipients of transplanted cells from younger donors tend to have better outcomes and increased survival. College and graduate students have become a key focus for marrow donor registration as they are young, healthy, well educated, more open to new information, and part of a community. 2 P a g e
Young adults represent the future of the society and have direct influence on family members and friends thus assessing their knowledge on peripheral blood stem cell donation (PBSC) are essential for better understanding the awareness level of the community. It will further help us in improving health education initiatives thereby removing the hurdles behind peripheral blood stem cell donation. 1.1 Statement of the Problem A study to assess the knowledge regarding peripheral blood stem cell donation among college students of selected institutions, Ernakulam 1.2 Objectives of the Study Assess the knowledge of the college students regarding peripheral blood stem cell donation. Find the association between the knowledge of college students with selected demographic variables. II. MATERIAL AND METHODS The research is a quantitative descriptivestudy which was conductedamong 81 Engineering students of Albertian instititute of sciences and technology, Ernakulam, Kerala. Participants who were present at the time of data were included in the study and selected by using simple random sampling technique. Data was collected by using a structured questionnaire which consisted of two parts: section A to assess the sample characteristics which included age, previous information received on PBSC and section B consisted of 20 structured questions to assess the knowledge of college students on PBSC. The tool was developed based on extensive review and validated by five experts from the field of medicine and nursing. Ethical clearance was obtained from the thesis committee of AIMS, Kochi. Data was collected after receiving written permission from the Principal of Albertian instititute of sciences and technology with written informed consent of the subjects. Then the self-administered questionnaires were distributed to research participants and collected on the same day. Approximate time taken for completion of the tool is 20 minutes. After collecting the questionnaire a life savers guide on PBSC prepared by Datri agency of PBSC was distributed to the research participants to promote their awareness. Each right answer received the score of one and wrong answer received score of zero. The knowledge score obtained were categorized into three levels: inadequate ( 50% of score), moderately adequate (50-75% of score) and adequate (>75% of score)after considering the importance of stem cell donation in present scenario.descriptive statistics was used to evaluate the demographic variable and knowledge level. Chi square was used to find the association between demographic data and knowledge of college students on PBSC. III. RESULTS & DISCUSSION A total of 81 participants from Albertian institute of science and technology filled the questionnaire out of which 69(85.2%) were between the age group 18-20 years and 12(14.8%) were between the age group 21-23 years.there was a significant association between knowledge on stem cell donation and information received about PBSC (p<0.05) and majority of students (81.5%) were not aware about PBSC donation. 3 P a g e
Findings regarding the assessment of knowledge of college students revealed that out of 81 subjects, 56 (69.1%) were having inadequate knowledge, 25 (30.9%) having moderately adequate knowledge and none of them have adequate knowledge regarding PBSC(Figure 1) with the mean score of 9.63 and standard deviation ± 2.477. Fig 1: Distribution of Knowledge on Blood Stem Cell Donation A number of researches are available on various aspect of hematopoietic stem cell transplantation for effective treatment using peripheral blood stem cells worldwide. But, hardly any research has been reported in India regarding PBSC. However, the research focusing on awareness on PBSC is scarce. Nevertheless, how to encourage people to register for donating their hematopoietic stem cells is a challenge. To encourage more people to register for peripheral blood stem cell donation, it is needed to identify the basic information regarding hematopoietic stem cell donation. The present study revealed that majority of the subjects have inadequate knowledge (69.1%) which is consistent with the findings of the study by Miok Kim and Hyunmi Ahn in which it was found that Korean nursing students have little knowledge on the hematopoietic stem cell donation.[1]. The result has shown a significant relationship between knowledge and information received but 81.5% of the subjects have reported that they have not received any information regarding PBSC donation.a student having an experience of hematopoietic stem cell donation promotion showed higher knowledge and attitude in the study by Miok Kim and Hyunmi Ahn. This result proves the importance of providing information regarding the registration process to donate hematopoietic stem cells. In fact, indefinite anxiety regarding organ donation, and lack of detail information about the registration process were reported as the reason that people would not register for donating their organs. Therefore, the registration process is an important content that should be included in an education program or campaign for hematopoietic stem cell donation.[1] Based on the result from this study, a well-designed and developed promotion program that includes detail information regarding PBSC should be focused to college students. This will promote large pool of PBSC registration. Then more patients will get the stem cell transplantation and lead a productive life. IV. CONCLUSION Healthy stem cells are critical which are missing from the person whom another individual is a match for. Stem cell, when infused into the patient, will kick-start his/her system into action and gives him/her a chance to recover and live.college and graduate students are easily accessible and important group to target. Educational efforts on focusing on these target group can increase PBSC registration and have the potential to improve patient outcomes thus save lives. 4 P a g e
V. ACKNOWLEDGEMENT The authors wish to thank the management and Principal of Amrita College Of Nursing for providing facilities and support to carry out the research work reported in this paper. Also the authors wishes to thank the management and Principal of Albertian institute of science and technology, kalamassery, Kochi for permitting to conduct the research and appreciate their interest in promoting health related activity in their institute. A special acknowledgement to Datri agency for PBSC for their support and interest in study. REFERENCES [1]. Kim M, Ahn H. Student Nurses Knowledge, Attitude, and Intention for Hematopoietic Stem Cell Donation in Korea.Advances in information Sciences and Service Sciences(AISS) 2013 october; 5(15) Available from:http://www.aicit.org.pdf [2]. Stem Cell Transplant (Peripheral Blood, Bone Marrow, and Cord Blood Transplants). American cancer society Available from: http://www.cancer.org/acs/003215-pdf.pdf [3]. Ravi T. Stem Cell Treatment in India: Expert Highlights Potential and Challenges. 2011 NovemberAvailable from: http://www.medindia.net/news/healthinfocus/stem-cell-treatment-in-india. [4]. Vasconcellos A, Nunes A and Feller E. Knowledge, attitudes, and Behaviors Regarding the Bone marrow Registry among college and medical students in Rhode island.medicine & Health/Rhode island 2011 October; 94(10)Available from: www.rimed.org. 5 P a g e