Noyola-Pérez Andrés, Ribas-Muratori Rafaella, Vargas-Hernández Marco A, Saavedra-Salazar Laura, Frutos Cristóbal, Bonfim Carmem, Barroso-Duarte Fernando, Galeano Sebastián, Jaimovich Gregorio, Karduss Amado, Gómez-De León Andrés
Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, México.
Hospital de Clínicas, Curitiba, Brazil.
Transplant Cell Ther. 2025 Jan;31(1):47.e1-47.e9. doi: 10.1016/j.jtct.2024.09.025. Epub 2024 Oct 11.
Hematopoietic cell transplantation (HCT) is a complex and resource-intensive procedure that has become a critical treatment for certain hematologic conditions. However, in Latin America, access to HCT is limited compared to high-income countries, in part due to a lack of standardized training programs for HCT professionals. To address this gap, the Latin-American Bone Marrow Transplantation Group conducted a cross-sectional study to assess the current state of training programs in HCT and cellular therapy across the region. This study aimed to describe and analyze the availability, characteristics, and challenges of HCT training programs in Latin America, with a focus on identifying barriers and proposing solutions for improvement. A cross-sectional survey was sent to 127 recognized HCT centers across 14 Latin-American countries in December 2022. The survey collected data on institutional characteristics, training program structure, costs, and barriers to program development. Descriptive statistics were used to summarize the data, and comparative analyses were performed using Chi-square and Mann-Whitney tests. Of the 127 centers surveyed, 50 (39%) responded, with the majority located in Brazil (34%) and Mexico (30%). Among the respondents, 64% (n = 32) offered formal training programs lasting 6 months or longer. The most significant barriers reported were lack of funding (n = 21), limited number of transplant procedures (n = 15), and a shortage of qualified professors (n = 11). Proposed solutions included increasing student mobility opportunities (n = 28), enhancing program quality (n = 27), and improving access to funding (n = 15). Only 6% of programs offered exposure to CAR-T therapy, and fewer than half of the centers provided international rotations. This study highlights significant disparities in HCT training programs across Latin America, with most countries lacking access to formalized training. While Brazil and Mexico serve as regional hubs, other nations have limited or no training opportunities. Addressing these gaps through increased funding, international collaborations, and standardized curricula is essential to improving HCT training and ultimately patient care in the region.
造血细胞移植（HCT）是一个复杂且资源密集型的程序，已成为某些血液疾病的关键治疗方法。然而，在拉丁美洲，与高收入国家相比，获得造血细胞移植的机会有限，部分原因是缺乏针对造血细胞移植专业人员的标准化培训项目。为了弥补这一差距，拉丁美洲骨髓移植小组开展了一项横断面研究，以评估该地区造血细胞移植和细胞治疗培训项目的现状。本研究旨在描述和分析拉丁美洲造血细胞移植培训项目的可用性、特点和挑战，重点是识别障碍并提出改进解决方案。2022年12月，向拉丁美洲14个国家的127个认可的造血细胞移植中心发送了一份横断面调查问卷。该调查收集了有关机构特征、培训项目结构、成本以及项目发展障碍的数据。使用描述性统计来汇总数据，并使用卡方检验和曼-惠特尼检验进行比较分析。在接受调查的127个中心中，50个（39%）做出了回应，其中大多数位于巴西（34%）和墨西哥（30%）。在受访者中，64%（n = 32）提供为期6个月或更长时间的正规培训项目。报告的最主要障碍是资金短缺（n = 21）、移植程序数量有限（n = 15）以及合格教授短缺（n = 11）。提出的解决方案包括增加学生流动机会（n = 28）、提高项目质量（n = 27）以及改善资金获取渠道（n = 15）。只有6%的项目提供接触嵌合抗原受体T细胞（CAR-T）疗法的机会，不到一半的中心提供国际轮转。这项研究凸显了拉丁美洲造血细胞移植培训项目存在的显著差异，大多数国家无法获得正规培训。虽然巴西和墨西哥是地区中心，但其他国家的培训机会有限或根本没有。通过增加资金、开展国际合作和制定标准化课程来弥补这些差距，对于改善该地区的造血细胞移植培训并最终提高患者护理水平至关重要。
