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EBMT 2025 | Remaining challenges and barriers to stem cell transplantation access

In this video, Steven Devine, MD, National Marrow Donor Program (NMDP), Minneapolis, MN, comments on the remaining challenges and barriers to hematopoietic stem cell transplantation (SCT) access. Dr Devine notes that, with advances in transplantation practices, donor availability is no longer a key concern. However, other barriers such as financial toxicity and caregiver availability remain significant obstacles, and the NMDP is working to address these challenges. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.

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Transcript

Yes, so we believe that PTCy and other strategies are enabling us to knock down the HLA barriers, which used to be the biggest barrier to transplant as we can’t find a matched donor, but now we can find suitable donors for virtually all patients. But what we’re realizing is that, from data that we’ve collected directly from the patients and their caregivers on the studies that we’ve been conducting, we realize that patients are quite vulnerable from a financial standpoint, from other social determinants of health...

Yes, so we believe that PTCy and other strategies are enabling us to knock down the HLA barriers, which used to be the biggest barrier to transplant as we can’t find a matched donor, but now we can find suitable donors for virtually all patients. But what we’re realizing is that, from data that we’ve collected directly from the patients and their caregivers on the studies that we’ve been conducting, we realize that patients are quite vulnerable from a financial standpoint, from other social determinants of health. They suffer a lot of financial toxicity, even from their treatments before transplantation. They may lack insurance. They may have a lot of out-of-pocket costs. And so we’re trying to understand those better and developing interventions. For instance, NMDP provides financial support for patients. It doesn’t pay for the whole transplant, but it might help patients get to transplant. We’re learning that lack of a caregiver may also be a barrier. Not everyone has someone living with them all the time, like a spouse. So trying to help also look at reimagining what a caregiver means. And so many of these other barriers that prevent people from having a transplant, we need to understand better and we are dedicated to overcoming those as well.

 

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