Blood and Marrow Transplant Clinical Trials Network Study 1102 heralds a new era in hematopoietic cell transplantation in high-risk myelodysplastic syndromes: Challenges and opportunities in implementation

Erica D. Warlick, Celalettin Ustun, Astrid Andreescu, Anthony F. Bonagura, Andrew Brunner, Abhinav B. Chandra, James M. Foran, Mark B. Juckett, Tamila L. Kindwall-Keller, Virginia M. Klimek, Daniel F. Pease, David P. Steensma, Bryce M. Waldman, Mary M. Horowitz, Linda J. Burns, Nandita Khera

Research output: Contribution to journalComment/debatepeer-review

2 Scopus citations

Abstract

Lay Summary: People who have advanced myelodysplastic syndromes (MDS) may live longer if they get a bone marrow transplant (BMT) instead of other therapies. However, only 15% of people with MDS actually get BMT. Experts say community physicians and transplant physicians should team up with insurance companies and patient advocacy groups to 1) spread this news about lifesaving advances in BMT, 2) ensure that everyone can afford health care, 3) provide emotional support for patients and families, 4) help patients and families get transportation and housing if they need to travel for transplant, and 5) improve care for people of under-represented racial and ethnic backgrounds.

Original languageEnglish (US)
Pages (from-to)4339-4347
Number of pages9
JournalCancer
Volume127
Issue number23
Early online dateAug 10 2021
DOIs
StatePublished - Dec 1 2021

Bibliographical note

Funding Information:
Andrew Brunner received grants from the Evans Foundation and the National Institutes of Health and provided consulting and/or served on the advisory board for Celgene/BMS, Acceleron, Novartis, Agio, and Takeda. He also reports research support to his institution from Novartis, Celgene/BMS, Takeda, Aprea, H3Biomedicine, Janssen, AstraZeneca, and GSK. James M. Foran served on the advisory board and received honoraria from Novartis, Servier, Pfizer, BMS, Stemline, Taiho, Syros, Certara, and Sanofi and provided consulting and received honoraria from Revolution Medicine. He also reports research support to his institution from AbbVie, Boehringer Ingelheim, Actinium, Aprea, Aptose, H3Bioscience, Kura Oncology, Takeda, Trillium, Xencor, and Sellas. David P. Steensma provided consulting for Astex, BMS/Celgene, Taiho, Pharmaessentia, and Onconova. Celalettin Ustun received honoraria from Novartis and Blueprint. Tamila L. Kindwall‐Keller was a medical monitor for BMT CTN studies and was paid for time spent reviewing records of adverse events. Daniel F. Pease was a board member for Minnesota Society of Clinical Oncology, 2018‐2020. Anthony F. Bonagura is an employee of Optum and receives stock as part of his benefits. Bryce M. Waldman is co‐chair of the CIBMTR's Consumer Advocacy Committee, a patient committee to provide perspective. Abhinav B. Chandra is on the advisory board of Tempus Labs, is the chair of the Arizona Cancer Coalition, Treatment Steering Committee, Arizona Department of Health. The other authors made no disclosures.

Funding Information:
BMT CTN is an alliance of transplant centers, funded by the National Institutes of Health, which conducts multi‐institutional studies in the field of HCT and cellular therapy. In 2019, the Executive Committee of the BMT CTN established a Task Force on Evidence into Practice to develop a framework for strengthening dissemination and implementation efforts in the context of BMT CTN trials. The task force commissioned a working group to improve the implementation of the BMT CTN 1102 study results into practice change across disciplines. This working group was composed of diverse stakeholders, including HCT specialists, non‐HCT clinicians from academic and community practices, a leadership representative from a large national payer, and a patient advocate. This article summarizes the working group's efforts to emphasize the importance of this study and highlight potential barriers and opportunities for implementation from the point of view of different stakeholders. We discuss a framework for expanded transplant access for older patients with MDS highlighting current practice patterns, operational challenges, influence of health disparities on potential widespread implementation, risks and benefits of implementation, and the need for future initiatives.

Funding Information:
This work was supported by the Blood and Marrow Transplant Clinical Trials Network through grants from the National Heart, Lung, and Blood Institute (U10HL069294 and U24HL138660) and the National Cancer Institute.

Publisher Copyright:
© 2021 American Cancer Society

Keywords

  • MDS
  • allogeneic hematopoietic cell transplantation
  • expanded access
  • myelodysplastic syndromes
  • reduce intensity conditioning

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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