BLOG: Organizations partner to expand access to bone marrow transplant, cell therapy
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Bone marrow transplant and cellular therapies are the only known curative therapy for many patients with hematologic malignancies or other disorders of blood and immune systems.
After many decades of refining this therapeutic modality, we are now able to offer a hope for cure to many patients with cancers and other diseases.
In the United States, more than 8,000 allogeneic and 11,000 autologous transplants were performed in 2020. Despite the increased indications for bone marrow transplant (BMT), many patients still are unable to access this therapeutic modality.
Many factors influence whether a patient in need can access BMT. Barriers to access exist through the therapeutic continuum, from the time of diagnosis to referral, time to transplant, and post-transplant care and support.
Underrepresented racial/ethnic minorities, those with lower socioeconomic status, those who are uninsured and individuals who live in rural areas face these barriers to a much greater extent.
In an effort to reduce these barriers and find solutions to the disparity gap, the American Society for Transplantation and Cellular Therapy (ASTCT) and Be The Match-National Marrow Donor Program established a partnership to address issues related to awareness, poverty and racial/ethnic inequities in BMT.
These organizations conducted a workshop with key stakeholders in July to discuss the state of BMT and identify potential solutions to make this therapeutic modality accessible to all.
The proceedings of this workshop recently were published in Transplantation and Cellular Therapy.
For awareness, the team identified the need to create educational tools for referring physicians, update national guidelines for indications for BMT, and the need to partner with community organizations to deliver BMT education.
The poverty committee identified a need to focus on an assessment of the psychosocial and financial needs of patients to create state-based advocacy teams and better support systems for patients and families.
The race/ethnicity equity team identified the need for centers to understand the demographics of the communities they serve as the first step in understanding inequities in the delivery of BMT care.
A center-specific report that includes the expected demographics based on catchment area and referral base, and the composition of patients currently receiving BMT within programs, could help identify gaps across groups. These findings then could be utilized to generate center-specific solutions to reduce the inequity gap for underserved populations.
There are multiple factors that cause inequities in delivery of health care — BMT included — in the United States.
This project is going to require engagement and participation from multiple stakeholders across the BMT community and beyond for many years to come.
We have the unique opportunity to come together to improve the experience of the many patients who may benefit from BMT.
References:
- Auletta JJ, et al. Current use and outcome of hematopoietic stem cell transplantation: CIBMTR US summary slides, 2021. Available at: https://www.cibmtr.org/ReferenceCenter/SlidesReports/SummarySlides/pages/index.aspx. Accessed Dec. 16, 2022.
- Auletta JJ, et al. Transplant Cell Ther. 2022;doi: 10.1016/j.jtct.2022.09.020.
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