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Hematopoietic Stem Cell Transplant

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Pediatric Hematology-Oncology in Countries with Limited Resources

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Abstract

Hematopoietic stem cell transplant (HSCT) is a treatment option in many otherwise deadly conditions, but its development is a great challenge in limited resourced countries. These countries represent a heterogeneous group with widely different problems, so each new HSCT program must develop its own project on its particular settings. Before any HSCT program is envisaged a preestablished treatment protocol within a network to assure opportunity should be established including a referral center network with adequate first line treatment. A broad participative HSCT committee will lead to local sensible HSCT indications and transparent priorization of patients.

Seek sustainable funding, including government coverage, ONG and leaders (politics and private company) must assure new facility building, health team training, expensive specific tests payment, pharmacological agents supply, and program sustainability over time.

HSCT patients represent a complex clinical picture far beyond from HSCT team competence. Pediatric subspecialist services and intensive care teams must get involved in the treatment at pre-transplant assessment, transplant, and follow-up periods. To establish a twinning program or partnership with an experienced HSCT unit is the first step for achieving international accreditation standards and technical requirements. The final goal is to ensure that international accreditation requirements are met.

To establish local HSCT indications and contraindications and to review regularly ongoing results, difficulties, and progress is strongly advised. Once standard HSCT has been mastered, endeavour to also master more complex HSCT.

We present here our own experience and give general suggestions with practical guidelines based on local experience.

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Authors and Affiliations

  1. Bone Marrow Transplant Unit, Hospital Dr. Luis Calvo Mackenna, Antonio Varas 360, Providencia, Santiago de Chile, Chile

    Julia Palma M.D. & Cristián Sotomayor M.D.

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  1. Julia Palma M.D.
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  2. Cristián Sotomayor M.D.
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Correspondence to Julia Palma M.D. .

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Editors and Affiliations

  1. Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg Hospital, Tygerberg, South Africa

    Daniela Cristina Stefan

  2. Harvard Medical School, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts, USA

    Carlos Rodriguez-Galindo

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Palma, J., Sotomayor, C. (2014). Hematopoietic Stem Cell Transplant. In: Stefan, D., Rodriguez-Galindo, C. (eds) Pediatric Hematology-Oncology in Countries with Limited Resources. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3891-5_27

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  • DOI: https://doi.org/10.1007/978-1-4614-3891-5_27

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