To meet the needs of a growing and aging population, an additional 100 adult bone marrow/stem cell transplants per year for blood-related cancers will be required within the next three to four years.
Around 200 transplants were carried out at St James's Hospital in Dublin last year. The hospital recently celebrated 40 years since the first bone marrow transplant, carried out by a team led by haematologist Professor Sean McCann.
The hospital also conducted 31 CAR T cell therapies at the National Center for Adult CAR T Cell Therapy in 2023.
Speaking at an event to mark the anniversary, Health Minister Stephen Donnelly praised the efforts of current and former staff who have facilitated more than 3,750 bone marrow and stem cell transplants over the past 40 years.
Ministers acknowledged that they had not achieved the funding required for the National Cancer Strategy this year. But he was working with stakeholders to “secure” more funding by 2025 to build on the core funding achieved over the past few years.
St James's University CEO Professor Mary Day said transplant activity increased by 24% between 2013 and 2023. He said the need for CAR T-cell therapy has also increased significantly. Professor Day said the hospital was working with the National Cancer Control Program to meet the requirements for “the next iteration of the transplant programme”.
When you talk to medical independentConsultant haematologist Professor Paul Brown said the transplant unit was reconfigured into 21 private rooms more than 20 years ago with funding from the Department of Health.
“It’s fair to say that with the removal of CAR T, which has a separate program, and some rooms that have recently been set up for the young adult/youth program, we are essentially still operating for the adult program. . There are 21 rooms,” he said.
“What's remarkable when you look at productivity is that, for example, 20 years ago we were doing about 30 to 50 transplants a year, whereas now we're doing 200 transplants a year. So we're doing more than four times as many treatments in the same number of rooms… We've made some progress in terms of staffing… So obviously the challenge is how do we do that? The question is whether it will be expanded further.”
Blood cancers occur most often in people over the age of 50. Professor Brown said “we will probably need to be able to offer 300 transplants within the next three to four years” to meet patient needs.
Professor Brown also noted the success of CAR T cell therapy programs and the growing need for these therapies.
“The outcomes that we are achieving with that program are better than anywhere else in the world in terms of outcomes. We currently have a significant number of patients with lymphoma, the main disease for which CAR T is currently available, and since the program began, are cured or remain in long-term remission.”
CAR T-cell therapy may be an appropriate treatment for more conditions. “The challenge there is obviously to deliver that service across Ireland in a way that is efficient and accessible to all patients.”
St James's University is currently participating in the first international clinical trial investigating CAR T-cell therapy as a first-line treatment for multiple myeloma.
