Each allogeneic hematopoietic stem cell transplant (allo-HSCT) is a personalized journey.
No paths are exactly alike,
but the outlook is the same:
hope on the horizon.
Join us on a new journey to extend the promise of allo-HSCT to more patients in need.
with more transplants for more waiting patients?
with optimized solutions and better outcomes?
with a straightforward experience for patients?
Over 18,000 new patients with hematologic malignancies are considered for allogeneic transplant each year, initiating their journey of hope.1
ALLO-HSCT OFFERS A CRITICAL ADVANTAGE to these patients by significantly improving survival rates when they proceed to transplant earlier in their treatment journey.2,3
Allogeneic transplant is a POTENTIALLY CURATIVE TREATMENT for patients with hematologic malignancies, but despite our achievements as a community, the transplant journey remains challenging.2
Every year, MORE THAN 10,000 PATIENTS who could benefit from allo-HSCT do not receive a transplant, and those who do experience anxiety and face challenges across the entire transplant journey.10,11
Racial disparities contribute to the lack of access to allo-transplant, and MINORITY PATIENTS ARE FAR LESS LIKELY to find a suitable donor.12,13,14
Once referred to a transplanter, the determination of allo-HSCT eligibility and decision to proceed is complex, and reliant on clinical, non-clinical, and donor factors.11
The search for a donor source requires the full transplant team and may be unpredictable due to donor accessibility and the possibility of donor attrition. Selection of a donor source is ultimately at the discretion of the transplanter, and acquisition can range from 1 to 14+ months.15,16
Patients undergo myeloablative or reduced intensity conditioning before their infusion. In preparation for transplantation, and for the subsequent recovery period after undergoing allo-HSCT, patients need to secure a full-time caregiver and a strong support system.2,11
Day Zero represents the day of infusion of stem cells and also the beginning of the monitoring period, which requires careful planning and preparation by the transplant team, the patient, and their caregiver.2
The time from transplant to engraftment is a key indicator of transplant success, and the days following transplant are critical for monitoring of patient outcomes. This period of monitoring continues even after engraftment and discharge, with transplanters consistently following up to mitigate complications and track progress.2,17
For minority patients, additional barriers exist throughout the journey, with ACCESS TO A DONOR VARYING GREATLY BY RACE.
In the U.S., African Americans are 2–3 times less likely than White Americans to find a matched unrelated donor, and disproportionately receive a mismatched graft: 41% of the time, as compared to 14% for White Americans.38-40
Probability of identifying an 8/8 HLA-matched
unrelated available adult donor by race13
White patients of European descent
75%
White patients of Middle Eastern or North African descent
46%
Hispanic patients (includes Mexican, Hispanic South
or Central American, and Hispanic Caribbean)
34%–40%
Asian patients (includes Chinese, Korean, South Asian,
Japanese, Filipino, Southeast Asian, and Vietnamese)
27%–42%
Black patients (includes African American, African,
Black South or Central American, and Black Caribbean)
16%–19%
Data obtained from the National Marrow Donor Program registry was used to predict the likelihood of identifying a suitable donor for patients in each group.
Cord Blood increases minority patients’ access to a suitable graft with less strict HLA matching as compared to adult donors.43,44 However, a single unit of cord blood may not supply enough hematopoietic cells for engraftment often requiring a second cord blood unit, preventing widespread adoption of cord blood transplantation.13
Haplo-related Transplant promises an almost universal match for many patients, but practical and clinical limitations pose considerable risks.45 Most patients of African ancestry do not have a suitable haplo-related donor; in a single-center study, only 44% of African Americans were able to identify a suitable HLA-haplo-related relative.42,46 Haplo-related transplants also often lead to high incidences of graft rejection and graft versus host disease (GvHD).45
Determination of transplant success is complex, and requires EVALUATION OF MULTIPLE PERFORMANCE INDICATORS across a period of time.
Transplant physicians and healthcare providers must manage outcomes while also seeking opportunities to increase equity in transplant.
But today, as NEW VISTAS IN CELL ENGINEERING AND TECHNOLOGY EMERGE, innovations will lead us to the next step in expectations for donor sources and transplant outcomes.
EX VIVO
EXPANSION
NOVEL
HLA TYPING
OPTIMIZATION
OF CONDITIONING REGIMENS
SELECTION OF
OPTIMAL DONOR SOURCE
GvHD
PROPHYLAXIS
AND TREATMENT
GRAFT ENGINEERING
AND ADOPTIVE IMMUNOTHERAPY
SUPPORTIVE
CARE
HEALTH EQUITY
AND ACCESS AMONG MINORITIES
