Bone marrow stem cell transplantation is an extremely expensive procedure. But in some oncological diseases, it can save the lives of patients, including children.
Since there is already a lot of experience with bone marrow transplants worldwide, experts have gathered enough data about which transplant procedures are actually needed and which can be safely saved to reduce the total cost of transplants, especially in middle-income countries.
Pediatric hematologist-oncologist, stem cell transplant specialist Lawrence B. Faulkner (Italy) told NEWS.am Medicine that bone marrow transplantation, like any complex medical procedure, often involves many complex and expensive drugs, equipment, and procedures, the use of which, however, is not always supported by scientific evidence.
“Our approach is that if there is no evidence that this expensive and complicated procedure can have a positive effect on the transplant outcome, we will not support it, we will not pay for it,” he said. “Many transplants have already been performed, and enough data have been collected about which procedures are not so important within the framework of transplantation, and which ones should not be skimped on.”
According to him, in many centers where bone marrow stem cells are transplanted, it is accepted that there should be complete sterility in the ward, the air should be specially filtered, there should be positive pressure, etc. However, as the specialist noted, the truth is that there is no scientific evidence that all of this somehow affects the outcome of the transplant and increases the probability of survival of the patients.
If there is no such evidence, it may make sense to abandon this desire to maintain complete sterility in the ward, as it is quite expensive. In addition, bone marrow transplants use a number of really expensive drugs, but Dr. Faulkner says the same results can often be achieved using less expensive drugs. And all such measures can help to reduce the cost of this procedure several times, which is very important, especially for middle-income countries.
Speaking about the successes and problems in bone marrow stem cell transplantation in Armenia, Faulkner noted that the results here are quite good, as 80 percent of transplants are successful, which means that the center where these procedures are performed in Armenia is working as it should, and there is absolutely no reason for children with diseases for which this transplant can be effective to travel abroad for this procedure.
But it is true that, according to the specialist, there are also problems in this field.
“Nurses play a very important role in the field of transplantation, and I believe that nurses who specialize in this field should earn much more [salary]. But now they are paid less than they deserve,” said the specialist.
In addition, in his view, nurses, especially those who work with cancer patients and help with bone marrow transplantation, should raise their qualification level, participate in international conferences, and take master classes on a regular basis. And so that they do not have problems with communication with all this, the management of their clinics should encourage them to learn English.
Faulkner is a speakers at the International Society of Paediatric Oncology (SIOP) Asia 2023 XV Congress, which started Thursday in Yerevan. Within the framework of this event, he will give a lecture Sunday, entitled “Transplantation/cell therapy service start-up and sustainability in middle-income countries.”