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Bone marrow transplantation in Malaysia
1Department of Paediatrics, Faculty of Medicine University of Malaya, Kuala Lumpur, Malaysia.
Insights
Malaysia
Area of Science:
- Pediatric Hematology Oncology
- Transplantation Immunology
Background:
- The only Bone Marrow Transplant (BMT) center in Malaysia exclusively serves pediatric patients.
- Since 1987, the center has performed 89 BMTs utilizing reverse barrier nursing techniques.
Purpose of the Study:
- To evaluate the efficacy and cost-effectiveness of a pediatric Bone Marrow Transplant (BMT) program in Malaysia.
- To compare outcomes, including survival rates, infection rates, and graft-versus-host disease (GVHD), with international standards.
Main Methods:
- Retrospective analysis of 89 pediatric BMT cases performed between 1987 and the present.
- Application of reverse barrier nursing techniques throughout the study period.
- Data collection on survival rates, infection complications, GVHD, interstitial pneumonitis, and transplant costs.
Main Results:
- An overall survival rate of 73% was achieved, with most survivors leading normal lives.
- Early and late infection rates were 46% and 13%, respectively, comparable to international benchmarks.
- Graft-versus-host disease (GVHD) and interstitial pneumonitis were less frequent and severe compared to Western centers.
- Early septicemia occurred in 36% of cases, with an immediate mortality rate below 10%.
Conclusions:
- The Malaysian pediatric BMT program demonstrates favorable outcomes, including high survival rates and manageable complication rates.
- The program is cost-effective, with an average cost of US $8000 per transplant, significantly lower than overseas options.
- The established BMT program is simple, effective, and economically viable for pediatric patients in Malaysia.
Abstract:
The sole BMT centre in Malaysia caters only for children. Since 1987, 89 transplants have been performed using reverse barrier nursing techniques. The overall survival rate is 73% with the majority of survivors leading normal lives. The early and late infection rates of 46% and 13%, respectively, are comparable to those of other centres. Although the early septicaemia rate is 36% the immediate mortality rate is < 10%. GVHD is less frequent and severe and the interstitial pneumonitis rate lower than that in the West. The average cost of US $8000 per transplant is much lower than the cost of a transplant performed overseas. Thus we believe that our paediatric BMT programme is simple and cost-effective.