The 50th Annual Meeting of the European Society for Blood and Marrow Transplantation: Patient Advocacy – Poster Session (P808-P815)
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October 8, 2024
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0 min
Global Utilization and Patient Experience in Haematopoietic Stem Cell Transplantation
Overview
The 2022 Lymphoma Coalition Global Patient Survey revealed significant variation in autologous haematopoietic stem cell transplant (aHSCT) utilization across lymphoma subtypes and regions, with younger patients more likely to receive aHSCT. Additionally, a multi-disciplinary dietetic prehabilitation service for HSCT patients demonstrated high patient satisfaction and perceived benefit.
Background
Autologous haematopoietic stem cell transplantation (aHSCT) is a key therapeutic option for lymphoma and chronic lymphocytic leukaemia (CLL), yet global utilization patterns remain incompletely understood. Prehabilitation services, including dietetic support, have emerged to optimize patient outcomes prior to HSCT. Understanding treatment patterns and patient-reported experiences can guide improvements in care delivery and equity across regions.
Data Highlights
| Parameter | Value |
|---|---|
| Number of survey respondents | 5280 patients from 66 countries |
| Mean age difference (aHSCT vs no aHSCT) | 51 vs 57 years (p < 0.0001) |
| aHSCT utilization by region | Middle East & Africa 31%, South America 23%, Europe 13%, Asia-Pacific 11%, North America 4% |
| Subtypes with ≥20% aHSCT use | Peripheral T-cell, Mantle Cell, Angioimmunoblastic T-cell, Anaplastic Large Cell, Adult T-cell, Diffuse Large B-Cell, Other Aggressive Lymphoma |
| Patients receiving aHSCT with additional treatments | Over 70% |
| Patients with relapse after aHSCT | Approximately 60% |
| CAR-T use in aHSCT patients | Significantly elevated (OR=5.57; 95% CI=3.55–8.71) |
| Dietetic prehabilitation patient response rate | 50% (41 patients) |
| Patients strongly agreeing dietetic input was clear and empowering | 100% |
| Patients feeling listened to and questions answered | 100% |
| Patients reporting benefit from dietetic service | 97% |
Key Findings
- Younger patients are significantly more likely to receive aHSCT compared to older patients.
- There is marked regional heterogeneity in aHSCT utilization, with highest rates in Middle East and Africa and lowest in North America.
- Major lymphoma subtypes show variable aHSCT use, with seven subtypes having ≥20% incidence.
- Most patients receiving aHSCT undergo multiple treatment modalities, including chemotherapy, immunotherapy, radiation, and steroids.
- Relapse after aHSCT is common, occurring in approximately 60% of patients.
- CAR-T therapy use is significantly higher among patients who have received aHSCT.
- Multi-professional dietetic prehabilitation services for HSCT patients are highly valued, with 100% of respondents reporting clear communication and empowerment to make dietary changes.
Clinical Implications
Clinicians should recognize that aHSCT is often part of a multi-modality treatment approach, especially in younger patients and certain lymphoma subtypes. Regional differences highlight the need for equitable access to transplantation services globally. Incorporation of multi-disciplinary prehabilitation, including dietetic support, can enhance patient experience and potentially improve transplant outcomes. Monitoring evolving therapeutic trends such as CAR-T integration is essential for optimizing patient care.
Conclusion
This global survey underscores the complexity of treatment pathways involving aHSCT and the importance of supportive services like dietetic prehabilitation. Continued longitudinal research will inform strategies to improve access and outcomes for lymphoma and CLL patients worldwide.
References
- Kalloger et al. 2024 -- Therapeutic utilisation across lymphoma and CLL: Lymphoma Coalition 2022 Global Patient Survey
- Morgan & Long 2024 -- Dietetic prehabilitation service evaluation in HSCT patients
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