Researchers have highlighted the barriers to stem cell donation impacting LGBTQIA+ individuals and the efforts needed to build more inclusive donor recruitment practices and offered guidance for donor recruitment organizations, registries, and transplant centers worldwide to advance a more inclusive transplant system. This information was presented by Schneidman et al at the 2023 Tandem Meetings | Transplantation & Cellular Therapy Meetings of the American Society for Transplantation and Cellular Therapy (ASTCT) and Center for International Blood and Marrow Transplant Research (CIBMTR) (Abstract 66).
Background
Allogeneic stem cell transplantation is a potentially curative treatment for patients with blood cancers, but this procedure requires a suitable donor. Health-care providers aim to find a donor with the same human leukocyte antigen (HLA) proteins as the patient to minimize the risk of a dangerous immune reaction. If an HLA-identical donor is not available within the family, health-care providers usually prefer an HLA-matched volunteer unrelated donor, if one is available.
Although men who identify as gay or bisexual and other men who have sex with men (gbMSM) are eligible to be volunteer unrelated stem cell donors, these populations have long been excluded from donation and represent a largely untapped donor pool. To inform efforts to recruit gbMSM individuals as donors, researchers conducted focus groups with gay, bisexual, queer, and transgender individuals who identified as male aged 17 to 35 years to explore their perspectives on the barriers and facilitators of stem cell donation. These discussions took place after participants were shown multimedia resources from Stem Cell Club’s Saving Lives With Pride campaign, developed in collaboration with the LGBTQIA+ community.
Study Methods and Results
In the new study, researchers found that nearly all 37 study participants were unaware that gbMSM individuals were eligible to donate stem cells, with many confusing stem cell vs blood donor eligibility criteria. Additionally, participants’ attitudes toward stem cell donation were negatively impacted by the exclusion of gbMSM individuals from blood donation, a lack of trust in the health-care system as a result of prior negative experiences, and associated concerns that gbMSM donors would be mistreated by health-care providers conducting stem cell transplants.
However, the researchers discovered that the participants may have felt inspired, empowered, and encouraged to donate after viewing multimedia resources featuring diverse representations of gbMSM individuals across the intersectionality of gender expression and sexual orientation with ancestry, culture, language, and disability who advocated for and were impacted by stem cell donations. The participants were also reassured by inclusive messages from health-care providers emphasizing that gbMSM individuals were wanted and needed, and promising that these donors would be treated with respect. The study also provided concrete advice on how to go about running campaigns to engage gbMSM individuals as donors.
Conclusions
“Stem Cell Club is very committed to including all [individuals] as donors—including those from groups who have been historically excluded from donation,” emphasized Warren Fingrut, MD, a Transplant Hematologist who is currently a Research Fellow in Cancer Care Disparities at Memorial Sloan Kettering Cancer Center and an MPH Student with the Harvard T.H. Chan School of Public Health as well as Director of Stem Cell Club. “Our findings show that members from the LGBTQIA+ community face unique barriers to [stem cell] donation—barriers that can be overcome when health-care providers and advocates come together to share messages of LGBTQIA+ inclusion,” he added.
The study was also one of the first oral abstract presentations at a major hematology and transplant meeting calling to advance inclusion for LGBTQIA+ individuals.
“This recognition of our work to advance inclusion for LGBTQIA+ [individuals] highlights a positive development in the field—that such work is being increasingly prioritized and valued,” highlighted Dr. Fingrut, concluding that “More work is needed to advance inclusion in [the field of] hematology, including for transgender and gender nonbinary [individuals], as well as for LGBTQIA+ patients [and] those with hematologic malignancies.”
Disclosure: For full disclosures of the study authors, visit tandem.confex.com.
