Role of Race/Ethnicity in Donor Decisions about Unrelated Hematopoietic Progenitor Cell Donation: Exploring Reasons for Higher Attrition among Racial/Ethnic Minorities

Multimedia resources to support the recruitment of committed hematopoietic stem cell donors: Perspectives of the most‐needed donors

“…From 2015 to 2018, 32% to 40% of potential donors on the Canadian Blood Services Stem Cell Registry who were identified as potential matches for patients did not proceed with donation 28 . Similar rates of attrition have been reported from the Anthony Nolan Stem Cell Registry in the United Kingdom and the National Marrow Donor Program of the United States 14,15 . Multiple studies have shown that donor ambivalence at or following registration is associated with attrition at subsequent stages in the donation process 16,26 .…”

“…Further, we acknowledge that videos capturing the attention of a specific group of donors may not be universally appealing, and that there may be unique benefits and drawbacks when developing multimedia either to engage a specific demographic or to have broad appeal. One reason to employ a more focused approach is that studies have identified numerous differences in the weighting of specific barriers to donation among different ethnic groups, including lack of awareness about the importance of and opportunities for donation, cultural and religious factors, and concerns regarding the ease of registration, as well as fear and mistrust toward stem cell donation and transplantation 14,16,23–25,58,59 . Additionally, studies have highlighted the effectiveness of educational interventions in specifically targeting barriers to donation within ethnic and minority groups 58,59 .…”

“…Despite over 36 million stem cell donors listed on registries in 54 countries around the world, 4 many patients remain unable to find a suitable unrelated donor. This is especially true for patients from ethnic/racial minority groups both within and outside North America, 5–13 who face lower rates of finding HLA‐matched donors due to a combination of smaller donor pools, disproportionate representation on individual registries and on the worldwide network, and ethnic/racial differences in genetic diversity and in attrition rates from donor registries 14–17 . Alongside the need for ethnic diversity on donor registries, young and male donors are preferred by transplant physicians due to their associations with improved outcomes in transplant recipients.…”

“…However, engaging specific donor demographics may require unique recruitment strategies to address specific barriers that prevent these groups from registering 3,22 . Previous work has shown that people from different ethnic/racial groups face different barriers to donation, including cultural and religious objections, unaddressed doubts and worries regarding the donation process, medical and work/family concerns, level of education, and uncertainty about the fairness of stem cell transplant allocation 14,16,23–25 …”

“…This is especially true for patients from ethnic/ racial minority groups both within and outside North America, [5][6][7][8][9][10][11][12][13] who face lower rates of finding HLAmatched donors due to a combination of smaller donor pools, disproportionate representation on individual registries and on the worldwide network, and ethnic/ racial differences in genetic diversity and in attrition rates from donor registries. [14][15][16][17] Alongside the need for ethnic diversity on donor registries, young and male donors are preferred by transplant physicians due to their associations with improved outcomes in transplant recipients. Specifically, younger donors are associated with improved recipient survival, [18][19][20] and male donors are associated with a possible decrease in the risk of recipient chronic graft-vs-host disease compared to multiparous women.…”