Hematopoietic Stem Cell Transplantation in Nepal: International Partnership, Implementation Steps, and Clinical Outcomes

Poudyal, Bishesh Sharma; Tuladhar, Sampurna; Neupane, Samir; Sapkota, Simit; Pandit, Subhas; Shrestha, Prem Raj; Poudel, Bishal; Bajaracharya, Malika; Sweiss, Karen; Patel, Pritesh; Mahmud, Nadim; Rondelli, Damiano

doi:10.1016/j.jtct.2022.02.011

Cited by 13 publications

(8 citation statements)

References 27 publications

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“…Haploid allogeneic HSCT showed a significantly lower total costs compared with dUCBT ( 18 ). A study conducted in Nepal reported the costs were $5,200, $10,000, and $13,300 for autologous HSCT, homozygous allogeneic HSCT, and haploid allogeneic HSCT, respectively ( 19 ). Compared with allogeneic HSCT, autologous HSCT has fewer restrictions on age, fewer post-transplant complications, faster recovery and higher quality of life, and transplantation is not limited by donors ( 4 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of childhood hematopoietic stem cell transplantation in Sichuan, China

Chen

Liu

Yang

et al. 2023

Front. Public Health

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ObjectiveTo analyze the inpatient cost of hematopoietic stem cell transplantation (HSCT) in children, so as to support clinical decision-making.MethodsStudy population were children who received HSCT in a tertiary children’s hospital (Sichuan, China) between 1st January 2020 and 31st December 2021. The median and interquartile range (IQR) of total cost at 100 days post transplantation were calculated. Subgroup analyses were conducted based on age, gender, transplantation types, and post-transplant complications. The cost differences between subgroups were analyzed to determine whether it had an impact on the total costs.ResultsA total of 142 pediatric patients were included in the study with a total cost of 250721.78 yuan (197019.16–315740.52, 1 yuan equals to around 0.15 US dollars). Drug costs accounted for 51.85% of the total cost, followed by medical service costs (12.57%) and treatment expenses (12.24%). In terms of transplantation types, the cost of autologous transplantation was lower than that of allogeneic transplantation (115722.98 yuan vs. 256043.99 yuan, p < 0.05), and the cost of human leukocyte antigen (HLA) complete matched was lower compared with that of partial matched (213760.88 yuan vs. 294044.84 yuan, p < 0.05). As for post-transplant complications, cases with <3 types of complications cost less than those with ≥3 types (212893.25 yuan vs. 286064.60 yuan, p < 0.05), and those with severity ≤ grade 2 cost less than those > grade 2 (235569.37 yuan vs. 280061.58 yuan, p < 0.05). Age and gender of patients did not lead to statistical differences in the total cost, while the transplantation types and post-transplant complications influenced the total cost.ConclusionThe total cost at 100 days post transplantation associated with HSCT treatment were substantial for pediatric patients. The HLA compatibility between donors and recipients, and post-transplant complications were important factors affecting the total cost.

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Section: Discussionmentioning

confidence: 99%

Cost analysis of childhood hematopoietic stem cell transplantation in Sichuan, China

Chen

Liu

Yang

et al. 2023

Front. Public Health

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“…If performed early, usually below 5 years of age, in an adequately chelated child, the cure rate approaches 90% [ 8 ]. The first bone marrow transplant was done in 2012 in Nepal, and since then, more than 150 transplants have been done at the Civil Service Hospital at a very affordable price compared to the rest of the world [ 9 , 10 ]. The average cost of bone marrow transplant for thalassemia at Civil Service Hospital patients is 11,500 USD (according to personal communication with the President of Nepal Thalassemia Society).…”

Section: Tablementioning

confidence: 99%

Thalassemia care in Nepal: In dire need of improvement

Poudyal

Devkota

Kouides

2023

eJHaem

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“…He further showed data that only 21 of 1,556 new drugs marketed between 1975 and 2004 were targeting diseases specifically prevalent in poor and low-income countries and therefore emphasised the need for conducting clinical research to address the local disease burden in LMICs [ 9 ]. He also mentioned that researchers from LMIC’s should take it as an opportunity and should collaborate with each other to generate good evidence [ 10 ]. He further discussed the challenges of conducting research in a LMIC setting.…”

Section: Highlights Of Daymentioning

confidence: 99%

Highlights from ecancer Choosing Wisely Nepal 2022: critical appraisal skills for evidence-based practice, 24th–25th September 2022, Kathmandu, Nepal

Poudyal¹,

Dulal²,

Shilpakar³

et al. 2022

ecancer

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The ecancer Kathmandu 2022 workshop on the 24th-25th September 2022 was the first ecancer conference organised in Nepal, a Southeast Asian nation sandwiched between India and China. It was focused on critical appraisal skills for evidence-based practice and was organised in partnership with the Karnali Academy of Health Sciences and the Civil Service Hospital from Nepal, and the Queen's Global Oncology Program from Canada. The workshop emphasised the need for critical thinking in understanding clinical research, and also motivated the delegates to undertake meaningful clinical research relevant to the local setting. The sessions highlighted the features of a good clinical research, identify pitfalls in the reporting of clinical trials, implementation of the research into locally relevant practice and development of local clinical guidelines. Furthermore, the faculty also discussed how to write a good scientific paper, the do's and don'ts of a systematic review and meta-analysis, the role of peer-review and how to do one properly and what do editors look for in evaluating papers submitted for publication. The audience learned the importance of finding a good mentor and fostering local and international collaboration. The local faculty also highlighted their own personal journeys and how mentorship and global collaboration played an important role in their own academic career. The enthusiastic panel discussion was a highlight of the programme where the delegates learned about several important topics from the faculties, such as work-life balance, the role of mentorship in building careers and building networks.

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Hematopoietic Stem Cell Transplantation in Nepal: International Partnership, Implementation Steps, and Clinical Outcomes

Cited by 13 publications

References 27 publications

Cost analysis of childhood hematopoietic stem cell transplantation in Sichuan, China

Cost analysis of childhood hematopoietic stem cell transplantation in Sichuan, China

Thalassemia care in Nepal: In dire need of improvement

Highlights from ecancer Choosing Wisely Nepal 2022: critical appraisal skills for evidence-based practice, 24th–25th September 2022, Kathmandu, Nepal

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