Setting up and sustaining blood and marrow transplant services for children in middle-income economies: an experience-driven position paper on behalf of the EBMT PDWP
Year: 2020
Type: article
Abstract: Severe blood disorders and cancer are the leading cause of death and disability from noncommunicable diseases in the global pediatric population and a major financial burden. The most frequent of these conditions, namely sickle cell disease and severe thalassemia, are highly curable by blood or bone marrow transplantation (BMT) which can restore a normal health-related quality of life and be cost-effective. This position paper summarizes critical issues in extending global access to BMT based on ground experience in the start-up of several BMT units in middle-income countries (MICs) across South-East Asia and the Middle East where close to 700 allogeneic BMTs have been performed over a 10-year period. Basic requirements in terms of support systems, equipment, and consumables are summarized keeping in mind WHO's model essential lists and recommendations. BMT unit setup and maintenance costs are summarized as well as those per transplant. Low-risk BMT is feasible and safe in MICs with outcomes comparable to high-income countries but at a fraction of the cost. This report might be of assistance to health care institutions in MICs interested in developing hematopoietic stem cell transplantation services and strengthening context appropriate tertiary care and higher medical education.
Source: Bone Marrow Transplantation
Authors: Lawrence Faulkner, Marta Verna, Attilio Rovelli, Rajat Kumar Agarwal, Rakesh Dhanya, Lalith Parmar, Amit Sedai, Ankita Kumari, Stalin Ramprakash, C. P. Raghuram, Pallavi Mehta, Sandeep Elizabeth, Sadaf Khalid, Aliya Batool, Sarah Khan Ghilani, Itrat Fatima, Tatheer Zara, Priya Marwah, Rajpreet Soni, Deepa Trivedi, Valentino Conter, Marta Canesi, Dosti Othman, Vian Faeq, Katharina Kleinschmidt, Akif Yesillipek, Catherine G. Lam, Scott C. Howard, Selim Corbacioglu, the Pediatric Diseases Working Party of the European Blood and Marrow Transplantation Group, Abdulah Al Jefri, Alice Bertania, Jochen Büchner, Andrè Willasch, Brenda Gibson, Tayfun Güngür, Marianne Ifversen, Roland Meisel, Ingo Müller, Kim Vetteranta, Paul Veys, Jacek Wachowiak
Institutions: University of Milano-Bicocca, Pakistan Institute of Medical Sciences, Care Institute of Medical Sciences, University of Regensburg, St. Jude Children's Research Hospital, University of Tennessee Health Science Center, King Faisal Specialist Hospital & Research Centre, Lucile Packard Children's Hospital, Stanford University, Oslo University Hospital, Goethe University Frankfurt, University of Glasgow, University Hospital Zurich, University Children's Hospital Zurich, Copenhagen University Hospital, Heinrich Heine University Düsseldorf, University Medical Center Hamburg-Eppendorf, University of Helsinki, Great Ormond Street Hospital, Helsinki Children's Hospital, Poznan University of Medical Sciences
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,860
OpenAlex ID: W3083176868