First Global Blood & Marrow Transplant [GlobalBMT] Conference in Kathmandu with experiences from Nepal, India, Singapore and Sri Lanka

Abstract

Eight lectures were presented and addressed: management of infectious complications in BMT, challenges of graft-vs-host disease (GVHD) in LMIC, challenges in establishing a BMT center in a LMIC, use of post-transplant high dose cyclophosphamide in BMT, methods and quality of stem cell collection and cryopreservation, role of autologous BMT in Non-Hodgkin’s lymphoma, cost-effectiveness and outcome of BMT vs new therapies in multiple myeloma, challenges of pediatric BMT. [...]these efforts can lack adequate quality standards and collabortation with international partners are important in starting new programs. Since a major challenge in each LMIC country is the unregulated cost of drugs, which represents a significant burden to the majority of patients and their families, it was agreed, based on the experience in Sri Lanka, that it will be useful to establish policies and regulations for the approval of new drugs in each country. [...]based on Sri Lanka experience, it is expected that in many LMIC only approved drugs may be available at lower prices. 3) Challenges of GVHD and rejection in LMICs: In India, GVHD represents a common cause of death among patients receiving an allogeneic BMT [9]. In non-malignant diseases such as thalassemia or aplastic anemia, the use of reduced intensity transplant regimens to lower toxicity, or the use of anti-thymocyte globulin (ATG) or alemtuzumab to reduce the risk of GVHD, leads to a higher risk of rejection, especially when utilizing bone marrow as a source of donor stem cells.