| Summary: | Donation of haematopoietic stem cells (HSCs), either through bone marrow (BM) or peripheral blood stem cell (PBSC) collection, is a generally safe procedure for healthy donors, although adverse reactions (ARs) are a known and definable risk. The physical reactions to donation have been established for some time, but less is known about factors predicting poorer experiences. In my thesis, I explore the donation experience in a prospective study involving 275 PBSC and 37 BM donors and focus attention on health-related quality of life (HRQOL) factors associated with recovery. Detailed interviews of 14 PBSC donors explore these findings using qualitative methodology. In addition, I characterise donors at risk of not meeting the HSC dose requested by transplant centres and therefore at risk of additional procedures and associated ARs. My key finding was that pre-donation HRQOL markers were the strongest predictors of time to recovery; poorer pre-donation physical health was associated with longer recovery (p = 0.017) and certain side-effects in PBSC donors, and poorer mental health was associated with longer recovery in BM donors (p = 0.03) and pain following PBSC donation (p = 0.003). Physical HRQOL scores declined significantly from pre-donation to 4 weeks post-donation, but returned to pre-donation values at 3 months. This decline was greater for BM donors. Mental HRQOL scores remained high throughout for PBSC donors, this may be explained by the strong, intrinsic motivation as well as remarkable determination donors described in the qualitative analysis.
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