Strategic priorities for hematopoietic stem cell transplantation in the EMRO region

Syed Osman Ahmed, Riad El Fakih*, Alaa Elhaddad, Amir Ali Hamidieh, Abdulghani Altbakhi, Qamar Un Nisa Chaudhry, Ali Bazarbachi, Salman Adil, Murtadha Al-khabori, Tarek Ben Othman, Javid Gaziev, Mohamad Khalaf, Salem Alshammeri, Sultan Alotaibi, Mohammed Alshahrani, Mohamed Amine Bekadja, Ahmad Ibrahim, Adel Mohammed Al-Wahadneh, Muna Altarshi, Ahmad AlsaeedAbdellah Madani, Miguel Abboud, Husam Abujazar, Mohamad Bakr, Ibraheem Abosoudah, Jean El Cheikh, Ahlam Almasari, Feras Alfraih, Helen Baldomero, Hassan Elsolh, Dietger Niederwieser, Naeem Chaudhri, Mahmoud Aljurf

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

The World Health Organization-designated Eastern Mediterranean region (EMRO) consists of 22 countries in North Africa and Western Asia with a collective population of over 679 million. The area comprises some of the wealthiest countries per capita income and some of the poorest. The population structure is also unique and contrasts with western countries, with a much younger population. The region sits in the heart of the thalassemia belt. Many countries have a significant prevalence of sickle cell disease, and cancer is on the rise in the region. Therefore, the strategic priorities for the growth and development of hematopoietic stem cell transplantation (HSCT) differ from country to country based on resources, healthcare challenges, and prevalent infrastructure. Thirty-one reporting teams to the Eastern Mediterranean Blood and Marrow Transplantation Group have active HSCT programs in 12 countries; allogeneic transplants outnumber autologous transplants, and the proportion of allotransplants for non-malignant conditions is higher in the EMRO region than in Western Europe and North America. The vast majority (99%) of allotransplants are from matched related donors. Matched unrelated donors and other alternate donor transplants are underutilized. The chance of finding a matched related donor for allografts is higher, with a significant chance of finding matched donors among non-sibling related donors. Reasons for relatively lower rates of transplants compared with other countries are multifactorial. Capacity building, development of newer centers, innovative funding, and better utilization of information technology are required to make transplantation as an accessible modality to more patients. Cost-effectiveness and cost-containment, regulation, and ensuring quality will all be priorities in planning HSCT development in the region.

Original languageEnglish
JournalHematology/ Oncology and Stem Cell Therapy
DOIs
Publication statusAccepted/In press - 2021
Externally publishedYes

Keywords

  • Eastern Mediterranean
  • EMRO
  • Hematopoietic cell
  • HSCT
  • Strategic priorities
  • Transplantation program
  • WBMT

ASJC Scopus subject areas

  • Hematology
  • Oncology

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