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  • Increasing access to transp...
    Gómez-De León, Andrés; Jiménez-Antolinez, Valentine; Rodríguez-González, Victor; Gutiérrez-Aguirre, César H.; MacWilliams, Maria E.; Sánchez-Larrayoz, Amaro F.; Martínez-Calderón, Karla; García Zárate, Valeria A.; Mancías-Guerra, Consuelo; Rodríguez-Zúñiga, Anna C.; Sánchez-Arteaga, Alexia; Colunga-Pedraza, Perla R.; Colunga-Pedraza, Julia; Cantú Rodríguez, Olga G.; Tarín-Arzaga, Luz; González-Llano, Oscar; Gómez-Almaguer, David

    Cytotherapy (Oxford, England), 2024-May-10
    Journal Article

    •Patient navigation is a process that helps patients overcome barriers to transplantation.•Collaboration with nonprofit patient support organizations is key.•Telemedicine is a useful tool for patient navigation in low- and middle-income countries. Hematopoietic cell transplantation (HCT) is a promising treatment for hematological diseases, yet access barriers like cost and limited transplant centers persist. Telemedicine-based patient navigation (PN) has emerged as a solution. This study presents a cost-free PN telemedicine clinic (TC) in collaboration with the National Marrow Donor Program. Aim: to assess its feasibility and impac on HCT access determined by the cumulative incidence of transplantation. In this single-center cohort study, patients of all ages and diagnoses referred for HCT participated. Two transplant physician-navigators established patient relationships via video calls, collecting medical history, offering HCT education and recommending pretransplant tests. The analysis involved descriptive statistics and intent-to-transplant survival assessment. One hundred and three patients were included of whom n = 78 were referred for allogeneic HCT (alloHCT), with a median age of 28 years. The median time from initial contact to the first consult was 5 days. The cumulative incidence of transplantation was 50% at 6 months and 61% at 12 months, with varying outcomes based on HCT type. Notably, 49 patients were not transplanted, primarily due to refractory disease, progression or relapse (57.1%). Autologous HCT candidates and physician referrals were correlated with higher transplant success compared to alloHCT candidates and patients who were not referred by a physician. Our pretransplant TC was feasible, facilitating access to HCT. Disease relapse posed a significant barrier. Enhancing timely physician referrals should be a focus for future efforts.