OYUNDELGER Norov, Prof., KHISHIGJARGAL Batsukh, MD. BMT and Hematology center First Central Hospital of Mongolia Introduction of Hematopoietic Stem Cell Transplantation in Mongolia
MONGOLIA
MONGOLIA Area: total: 1,5 million km 2 country comparison to the world: 19 Population: 2,9 million (2014 est.) country comparison to the world: 140 Population density: 1.88 person/km 2 country comparison to the world: 1 GDP - per capita (PPP): $3,996 (2013 est.) country comparison to the world: 108
MONGOLIA
Hematological healthcare service in Mongolia Provided at following 2 hospitals The First Central Hospital - for adult The National Center for Child - for children
First Central Hospital of Mongolia Founded in 1925 First Government Hospital in Mongolia 570 beds 710 Staff, including 170 physicians Only one Transplantation Center in Mongolia which performs kidney and liver transplantation First BMT case was performed in 2014
Why we need BMT? Blood cancer and other severe hematological disorder rate is increasing annually Current prognoses is poor in Mongolia Those patients who need BMT must travel abroad /high cost/ After returning these transplant patients need follow up check in Mongolia Home treatment is suitable for patients Successful BMT equals development of health care at national level
Acute leukemia incidence /adult/ Number of cases diagnosed at First Central Hospital 56 69 87 96 29 31 2000 2003 2006 2009 2012 2013
Blood cancer incidence for last 5 year 120 100 80 60 40 20 0 106 109 89 82 67 68 62 58 53 54 20 23 26 27 26 26 16 18 19 21 2009 2010 2011 2012 2013 AML ALL MM MPD
Statistical profile Age distribution of patients with blood cancer 3% 12% 31% <20 yrs 20-40 yrs 40-60 yrs >60 yrs 54%
BMT development project Started in 2011 by Prof. Oyundelger. M.D., Funding: Government and FCH BMT development project had 3 main goals: Human resources training Establishment of BMT unit Renovation and purchase of necessary laboratory equipments
BMT development project Human resources training: Most of our BMT staff received 1-3 month training at BMT center of Seoul St. Mary s Hospital, The Catholic University of Korea
Hematology and BMT Center Total staff 23, including hematologists; laboratory physicians; infectious disease specialist; ICU doctors; nurses and engineers
Cooperation parties for BMT Administration of FCH Seoul St.Mary s Hospital Other disciplinary departments BMT Department National Cancer Center National Transfusion Center
BMT development project Establishment of clean BMT unit facility. Including: Clean patient room Cell processing room Freezing room Apharesis unit BMT ICU section
Patient room
BMT Department
Patient room
Patient room
Patient room
Nursing station
ICU equipments
Cell freezing room
Apheresis unit
Food One of Mongolian BMT feature is specific method of meat processing which fit with mongolian people character.
BMT development project Renovation of necessary laboratory equipment included: Molecular Genetics: Real-Time PCR system/ab 7500/ DNA Sequencer /AB 3500/ Fragment analyzer Luminex flow cytometry Immunophenotyping: FACS Canto 2 Special chemistry: Automated capillary electrophoresis system Drug analyzer /Siemens/
Immunophenotyping FACS Canto 2
Molecular Genetics Luminex flow cytometry
Molecular Genetics Real-Time PCR system/ab 7500/ DNA Sequencer /AB 3500/
Molecular Genetics Fragment analyzer
International cooperation APBMT membership since 2011 BMT center of Seoul St. Mary s Hospital, The Catholic University of Korea China, No. 307 Hospital
First BMT Case in Mongolia: First BMT was performed 2014-Feb-27th 51 years old male patient; diagnosed 2013-April Multiple myeloma, LCD k type IIIa CTx 4 cycles of Vdex Аuto PBSCT Patient s current status is good Prof. J.W.Lee and colleagues from BMT center of Seoul St. Mary s Hospital
Future goals Further training of human resources To develop laboratory To establish national HLA-registry and cord blood bank To up-grade transfusion services In order to do so we need to acquire blood irradiation and TBI equipments To develop drug support
Future goals To treat more patients with Auto-BMT To introduce Allo-BMT case To cover treatment cost by health insurance To broaden our international cooperation
Thank you for your attention