The National Marrow Donor Program's Symposium on Hematopoietic Cell Transplantation in 2020: A Health Care Resource and Infrastructure Assessment

National Marrow Donor Program®, 3001 Broadway Street NE, Minneapolis, MN 55413, USA.
Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation (Impact Factor: 3.4). 12/2011; 18(2):172-82. DOI: 10.1016/j.bbmt.2011.10.004
Source: PubMed


Hematopoietic cell transplantation (HCT) is the only known curative therapy for many patients with life-threatening hematologic and oncologic diseases. It is estimated that the National Marrow Donor Program(®) (NMDP) will facilitate 10,000 transplants by 2015, double the current number. To better understand the existing personnel and center infrastructure for HCT in the country and to address system capacity challenges to the future growth of HCT, the NMDP convened a diverse group of stakeholders and thought leaders representing HCT physicians, physician assistants, nurse practitioners, nurses, pharmacists, other healthcare providers, HCT program directors, hospital administrators, payors, and professional organizations. Working groups were formed to identify: capacity issues because of shortages in human resources, structural constraints, and patient access barriers including diversity and healthcare disparity challenges; recommendations to address challenges; and stakeholders to engage. This report details the deliberations and recommendations of a national symposium, "Hematopoietic Cell Transplantation in 2020: A Health Care Resource and Infrastructure Assessment," held in September 2010.

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    ABSTRACT: The demand for unrelated haematopoietic cell (HPC) donors has risen threefold over the last decade, and is likely to continue to rise over the next 10 years. The time taken from diagnosis to transplant is recognised to adversely affect patient outcome, and provision of unrelated donors (UDs) has been identified as a key source of delay. Obstacles to provision of UD include: delays in referral to a transplant centre, awaiting sibling typing, lack of matched donors (particularly for those from ethnic minorities and/or with rare HLA phenotypes), low- or intermediate-resolution donor HLA typing, donor attrition from the registries, donor ineligibility on grounds of health and difficulties encountered transporting HPC across international borders. There are now over 18 million volunteer donors in registries worldwide, and efficiency has improved, at least in part, because of a switch from paper to electronic searches. As a result, the average time from search request to transplant is estimated to be less than half of what it was two decades ago. Furthermore, registries have developed a number of strategies designed to minimise delays and, ultimately, improve patient outcomes. These include: optimisation of donor numbers and ethnic mix through focused and selective recruitment; high-resolution typing at donor recruitment; cord blood banking with aggressive recruitment in ethnic minorities; early identification of those unlikely to find a match so alternative transplant options may be pursued in a timely manner, through use of HLA-based predictive algorithms; reduction of donor attrition; centralised, registry-based, donor identification services; and provision of a back-up donor.Bone Marrow Transplantation advance online publication, 9 April 2012; doi:10.1038/bmt.2012.54.
    Full-text · Article · Apr 2012 · Bone marrow transplantation

  • No preview · Article · Jun 2012 · Expert Review of Hematology
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    ABSTRACT: The National Marrow Donor Program(®) sponsored and organized, in partnership with the American Society for Blood and Marrow Transplantation, a series of symposia to identify complex issues affecting the delivery of hematopoietic cell transplantation (HCT) and collaboratively develop options for their solution. "Hematopoietic Cell Transplantation in 2020: A System Capacity Initiative" has utilized a deliberative process model to engage professional organizations, experts, transplant centers, and stakeholders in a national collaborative effort. Year II efforts emphasized data analysis and identification of innovative ideas to increase HCT system efficiency, address future capacity requirements, and ensure adequate reimbursement for HCT programs to meet the projected need for HCT. This report highlights the deliberations and recommendations of Year II and the associated symposium held in September 2011.
    Preview · Article · Oct 2012 · Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation
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