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Review
. 2021 Mar;56(3):536-543.
doi: 10.1038/s41409-020-0983-5. Epub 2020 Sep 7.

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

Lawrence Faulkner  1   2 , Marta Verna  3 , Attilio Rovelli  3 , Rajat Kumar Agarwal  4 , Rakesh Dhanya  4 , Lalith Parmar  4 , Amit Sedai  4 , Ankita Kumari  4 , Stalin Ramprakash  5 , C P Raghuram  5 , Pallavi Mehta  5 , Sandeep Elizabeth  4 , Sadaf Khalid  6   7 , Aliya Batool  7 , Sarah Khan Ghilani  7 , Itrat Fatima  8 , Tatheer Zara  8 , Priya Marwah  9 , Rajpreet Soni  9 , Deepa Trivedi  10 , Valentino Conter  3 , Marta Canesi  3 , Dosti Othman  11 , Vian Faeq  11 , Katharina Kleinschmidt  12 , Akif Yesillipek  13 , Catherine G Lam  14 , Scott C Howard  15 , Selim Corbacioglu  12 ; Pediatric Diseases Working Party of the European Blood and Marrow Transplantation Group
Collaborators, Affiliations
Review

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

Lawrence Faulkner et al. Bone Marrow Transplant. 2021 Mar.

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.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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