Leukemia & lymphoma · 2024
A Shared Care Model between community and transplant centers facilitates access to allogeneic and autologous transplantation.
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Fein Joshua A, McAuliffe Agnes, Fischer Kimberly, Brady Owen, Devlin Sean M, Willumsen Silvia, Ozcan Gonca, Montanaro Pat, Pristyazhnyuk Yelena, DiGiuseppe Joseph, Lahoud Oscar B, Perales Miguel-Angel, Pfister David G, Giralt Sergio, Dailey Mark, Yu Peter Paul, Sauter Craig Steven
Аннотация
Access to allogeneic and autologous hematopoietic stem cell transplantation (SCT) remains inadequate despite its curative potential across hematologic malignancies. In 2015, Hartford HealthCare (HHC) and the Memorial Sloan Kettering Cancer Center (MSK) established the Shared Care Model (SCM) with a primary aim of enhancing SCT access for HHC patients. The SCM comprises several components: an SCT-dedicated nurse-navigator, a health-information exchange for record sharing, telemedicine, and ongoing training of HHC clinicians in transplant patient selection and management. We evaluated the SCM's impact on SCT access across 126 patients with acute leukemia, myelodysplastic syndrome, and multiple myeloma from 2016-2020. The SCM facilitated 34 referrals. Socio-economic status of HHC referrals by Area Deprivation Index was significantly inferior (38 vs. 14, p < 0.001) when compared to 3,108 non-SCM referrals to MSK during the same period. Allogeneic recipients spent 68-247 days away from home, and autologous recipients 15-48, both requiring few subsequent visits to MSK.