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Increasing access to transplantation through telemedicine and patient navigation.
Gómez-De León, Andrés; Jiménez-Antolinez, Valentine; Rodríguez-González, Victor; Gutiérrez-Aguirre, César H; MacWilliams, Maria E; Sánchez-Larrayoz, Amaro F; Martínez-Calderón, Karla; García Zárate, Valeria A; Mancías-Guerra, Consuelo; Rodríguez-Zúñiga, Anna C; Sánchez-Arteaga, Alexia; Colunga-Pedraza, Perla R; Colunga-Pedraza, Julia; Cantú Rodríguez, Olga G; Tarín-Arzaga, Luz; González-Llano, Oscar; Gómez-Almaguer, David.
Afiliação
  • Gómez-De León A; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Jiménez-Antolinez V; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Rodríguez-González V; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Gutiérrez-Aguirre CH; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • MacWilliams ME; Be the Match, National Marrow Donor Program, Minneapolis, Minnesota, USA.
  • Sánchez-Larrayoz AF; Be the Match Mexico, National Marrow Donor Program, Minneapolis, Minnesota, USA.
  • Martínez-Calderón K; Be the Match Mexico, National Marrow Donor Program, Minneapolis, Minnesota, USA.
  • García Zárate VA; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Mancías-Guerra C; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Rodríguez-Zúñiga AC; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Sánchez-Arteaga A; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Colunga-Pedraza PR; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Colunga-Pedraza J; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Cantú Rodríguez OG; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Tarín-Arzaga L; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • González-Llano O; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico.
  • Gómez-Almaguer D; Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Monterrey, Nuevo León, Mexico. Electronic address: dgomezalmaguer@gmail.com.
Cytotherapy ; 26(10): 1193-1200, 2024 Oct.
Article em En | MEDLINE | ID: mdl-38775773
ABSTRACT

BACKGROUND:

Hematopoietic cell transplantation (HCT) is a promising treatment for hematological diseases, yet access barriers like cost and limited transplant centers persist. Telemedicine-based patient navigation (PN) has emerged as a solution. This study presents a cost-free PN telemedicine clinic (TC) in collaboration with the National Marrow Donor Program.

AIM:

to assess its feasibility and impac on HCT access determined by the cumulative incidence of transplantation.

METHODS:

In this single-center cohort study, patients of all ages and diagnoses referred for HCT participated. Two transplant physician-navigators established patient relationships via video calls, collecting medical history, offering HCT education and recommending pretransplant tests. The analysis involved descriptive statistics and intent-to-transplant survival assessment.

RESULTS:

One hundred and three patients were included of whom n = 78 were referred for allogeneic HCT (alloHCT), with a median age of 28 years. The median time from initial contact to the first consult was 5 days. The cumulative incidence of transplantation was 50% at 6 months and 61% at 12 months, with varying outcomes based on HCT type. Notably, 49 patients were not transplanted, primarily due to refractory disease, progression or relapse (57.1%). Autologous HCT candidates and physician referrals were correlated with higher transplant success compared to alloHCT candidates and patients who were not referred by a physician.

CONCLUSION:

Our pretransplant TC was feasible, facilitating access to HCT. Disease relapse posed a significant barrier. Enhancing timely physician referrals should be a focus for future efforts.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Telemedicina / Transplante de Células-Tronco Hematopoéticas / Navegação de Pacientes Limite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Telemedicina / Transplante de Células-Tronco Hematopoéticas / Navegação de Pacientes Limite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article