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
Department of Hematology & Medical Oncology, Weill Cornell Medicine, NewYork Presbyterian, New York, NY.
Memorial Sloan Kettering Cancer Center, New York, NY.
Leuk Lymphoma. 2025 Apr;66(4):713-720. doi: 10.1080/10428194.2024.2434171. Epub 2024 Dec 6.
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, < 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.
尽管同种异体和自体造血干细胞移植(SCT)对血液系统恶性肿瘤具有治愈潜力,但目前其可及性仍然不足。2015年,哈特福德医疗保健公司(HHC)与纪念斯隆凯特琳癌症中心(MSK)建立了共享护理模式(SCM),其主要目标是提高HHC患者接受SCT的可及性。SCM包括几个组成部分:一名专门负责SCT的护士导航员、一个用于记录共享的健康信息交换平台、远程医疗以及对HHC临床医生进行有关移植患者选择和管理的持续培训。我们评估了2016年至2020年期间SCM对126例急性白血病、骨髓增生异常综合征和多发性骨髓瘤患者接受SCT可及性的影响。SCM促成了34例转诊。与同期向MSK转诊的3108例非SCM患者相比,根据地区贫困指数,HHC转诊患者的社会经济地位明显较低(38比14,<0.001)。同种异体移植受者离家68 - 247天,自体移植受者离家15 - 48天,两者后续去MSK就诊的次数都很少。