2014 nguyen tan binh, huynh nghia, tran quoc tuan huynh van man

2014 nguyen tan binh, huynh nghia, tran quoc tuan huynh van man

NGUYEN TAN BINH, HUYNH NGHIA, TRAN QUOC TUAN
HUYNH VAN MAN, BAO MINH HIEN, HUYNH DUC VINH PHU,
NGUYEN HANH THU, PHU CHI DUNG, TRAN VAN BINH, TRAN VAN BE
2014
1.
Current status of HSCT in Vietnam
2.
Transplant activities of BTH
3.
Challenges
4.
Future plans
2
•
•
•
units •
04
01
unit
108th Military Hospital
Pediatric Institute
Bach Mai Hospital
National Institute of Hematology
and Blood Transfusion (NIHBT)
• Nghe An Oncology Hospital
01
unit
02
units
• Hue Central Hospital
Population:
90 million (2013)
• Cho Ray Hospital
• Blood Transfusion Hematology Hospital
(BTH)
3
Center
Set up
Year
No of
cases
Allo
Auto
BTH Hospital HCM City
1995
161
77
84
HUE central hospital
2003
7
7
108 Military Hospital
2004
7
7
Pediatric Institute
2006
17
17
NIHBT Institute
2006
140
60
Cho Ray Hospital
2013
5
5
Bach Mai Hospital
2013
5
5
Nghe An Oncology Hospital
2013
3
3
Total
345
80
154
191
4
5 cord blood banks in Vietnam:
1. Cord blood bank of Blood Transfusion
Hematology Hospital in HCM city (since 2002)
2. Cord blood bank of National Institute of
Hematology and Blood Transfusion in Hanoi
(since 2013)
3. Cord blood bank of Pediatric Institute in Hanoi
(since 2011)
4. Private cord blood bank of Mekostem (since
2008)
5. Private cord blood bank of Vinmec (since 2014)
5
6
Stem cell transplantation
department at BTH:
• was established in 1995
• was the first tranplant unit in
Vietnam.
• Facilities: Sterile isolation
rooms, Positive pressure
ventilation, HEPA Filtration
system
• Has had the corporate programs
to many centers of Taiwan,
Japan, U.S, Belgium, France,
Singapore…
7
Patient room
8
First case of
allogeneic BMT
First case of UCB
transplant
1995
1996
First case of
autologous BMT
2013
First case of
haploidentical
SCT
2002
9
25
Total: 161 cases
No of cases
20
15
Allogeneic
Autologous
10
5
0
10
No of patients
N = 161
Median age at transplant
35 (range: 4 – 63)
Male : Female
1 : 1.03
Allogeneic
HLA-identical
73
SCT
Haploidentical
3
Autologous SCT
84
Syngeneic SCT
1
11
12
Cord Blood
BM
2.8%
7.2%
PBSC
90%
13
Regimen
Diseases
Bu/Cy
AML, ALL, Thalassemia, MDS,
CML
Bu/Flu ± ATG
AML, CMML
Bu/Flu/ARA-C/ATG AML (haploidentical SCT)
BEAM, BEAC, LEED Lymphoma
High dose
Multiple myeloma
melphalan
Cy+ATG or
Aplastic anemia
Cy+Flu+ATG
14
• Median cost of allogeneic SCT: 40,000 USD
(including cost of stem cell collection).
• Median cost of autologous SCT: 20,000 USD
(including cost of stem cell collection)
• National insurance covered one-third of
transplant cost
15
•
First cord blood bank in Vietnam
•
Established in 2002
•
Gathering cord blood stem cells
from multiple G/O hospitals in
HCMC (both private and public)
• Member of Asia CORD and
NetCORD.
• 3,000 samples stored
16
17
• Recently, National Birth Control Program has
produced small family size
•  Difficult to find suitable sibling donors.
• Unavailability of National Bone Marrow Donor
Registry
• Many patients can not afford high costs of
transplantation.
• TBI has not been established
18
Set up the National Bone Marrow Donor Registry
 Increase haploidentical stem cell transplantation
Extend the applicability of RIC transplantation to
older patients.
 Collaborate with international stem cell centers
Studies in progress: haploidentical SCT, cord
blood SCT, DLI-post transplant.
19
20