Hematopoietic Stem-Cell Transplantation in the Resource-Limited Setting: Establishing the First Bone Marrow Transplantation Unit in Bangladesh

J Glob Oncol. 2018 Sep:4:1-10. doi: 10.1200/JGO.2016.006460. Epub 2016 Dec 21.

Abstract

Purpose: Treatment of malignant and nonmalignant hematologic diseases with hematopoietic stem-cell transplantation (HSCT) was first described almost 60 years ago, and its use has expanded significantly over the last 20 years. Whereas HSCT has become the standard of care for many patients in developed countries, the significant economic investment, infrastructure, and health care provider training that are required to provide such a service have prohibited it from being widely adopted, particularly in developing countries.

Methods: Over the past two decades, however, efforts to bring HSCT to the developing world have increased, and several institutions have described their efforts to establish such a program. We aim to provide an overview of the current challenges and applications of HSCT in developing countries as well as to describe our experience in developing an HSCT program at Dhaka Medical College and Hospital in Bangladesh via a partnership with health care providers at Massachusetts General Hospital.

Results and conclusion: We discuss key steps of the program, including the formation of a collaborative partnership, infrastructure development, human resource capacity building, and financial considerations.

Publication types

  • Review

MeSH terms

  • Bangladesh / epidemiology
  • Bone Marrow Transplantation / methods
  • Cancer Care Facilities
  • Delivery of Health Care* / methods
  • Delivery of Health Care* / organization & administration
  • Developing Countries
  • Health Resources* / economics
  • Health Resources* / statistics & numerical data
  • Health Workforce
  • Hematopoietic Stem Cell Transplantation* / methods
  • Hospitals, University
  • Humans
  • Patient Care Team