Siblings who donate bone marrow to their brothers or sisters are more adaptive at school, their teachers tell researchers, but the children themselves aren't so sure. These same sibling-donors report more anxiety and lower self-esteem than do non-donor siblings of transplant patients.
And, the researchers note, both donor and non-donor children sometimes experience post-traumatic stress after their siblings receive the transplant.
Wendy L. Packman, J.D., Ph.D., and colleagues from the Pacific Graduate School of Psychology, Palo Alto, CA, and the University of California at San Francisco, studied 44 siblings of children who survived bone marrow transplantation. Of these, 21 donated their bone marrow, 23 did not. The findings are published in the August issue of the Journal of Developmental and Behavioral Pediatrics.
"Siblings of children undergoing bone marrow transplantation do live with the intense stress of the illness," the authors write. "Siblings are often separated from both parent and patient."
When the researchers questioned the children, their parents and their teachers about this stress, the children who were donors said they had more anxiety and lower self-esteem than the children who were not donors, but the teachers said the children-donors showed more adaptive skills in school and those who were not donors had more school problems.
Bone marrow transplants are employed to treat an increasing number of disorders and are important in treating hemotologic, malignancy and genetic disorders in children.
"Bone marrow transplantation affects the life of the child at home and in school," the authors write. "Sibling adjustment must be monitored during the patient's regular follow-up visits. They should be seen as an integral part of the family system and acknowledged as important participants in the treatment process."
This is the first study of siblings to examine differences between donors and non-donors. Because of the limited size of the sample available from one center, the authors recommend a larger study to confirm the findings.
The Journal is published bi-monthly by the Society of Developmental and Behavioral Pediatrics.
Dr. Wendy L. Packman may be contacted at (617) 355-6680.
Contact: Paul H. Dworkin, MD, editor