An additional 100 adult bone marrow/stem cell transplantations per annum will be required for blood-related cancers within the next three-to-four years to meet the needs of a growing and ageing population.
Last year, approximately 200 transplantations were conducted at St James’s Hospital, Dublin. The hospital recently marked the 40th anniversary of the first bone marrow transplantation conducted by a team led by haematologist Prof Shaun McCann.
In 2023, the hospital also undertook 31 CAR T-cell therapy treatments at its National Centre for Adult CAR T-cell therapy.
Speaking at an event to mark the anniversary, Minister for Health Stephen Donnelly praised the efforts of current and former staff who have facilitated over 3,750 bone marrow/stem cell transplantations over the past four decades.
The Minister acknowledged he had not achieved the desired funding for the national cancer strategy this year. However, he was working with his officials “to make sure” there is more funding for 2025 to build on core funding achieved in previous years.
Prof Mary Day, CEO of St James’s, said transplant activity had increased by 24 per cent between 2013 and 2023. She said the requirement for CAR T-cell therapy was also rising substantially. Prof Day said the hospital is working with the National Cancer Control Programme to meet the requirements “for the next iteration of the transplant programme”.
Speaking to the Medical Independent, Consultant Haematologist Prof Paul Browne said the transplant unit was reconfigured into 21 single rooms over 20 years ago on foot of funding from the Department of Health.
“It is fair to say that – taking out the CAR T which has got a separate programme, and a number of rooms that were put in place recently for the young adult/adolescent programme – for the adult programme we are still operating out of basically the 21 rooms,” he noted.
“What is remarkable when you look at the productivity is that compared to say, 20 years ago, when we were doing approximately 30-to-50 transplants per year, we are now doing 200. So we are doing more than four times the number of treatments with the same numbers of rooms…. We have had some developments in staffing…. So clearly the challenge would be how do we expand that further.”
Blood cancers occur more commonly in people over 50. Prof Browne said “we will probably need to be able to offer 300 transplants within the next three-to-four years” to meet patient needs.
Prof Browne also noted the success of the CAR T-cell therapy programme and an increasing need for these therapies.
“The results we are achieving with that programme are as good as anywhere in the world in terms of outcome. We now have a substantial number of patients with lymphoma, which is the main disease for which CAR T at the present time is available, who are cured or remaining in long-term remission since the programme commenced.”
It is likely CAR T-cell therapy will become an appropriate treatment for more conditions. “The challenge there, clearly, will be in delivering that service in Ireland across the country in a way that is efficient and accessible for all of our patients.”
Currently, St James’s is involved in the first international clinical trial investigating CAR T-cell therapy as a first-line treatment in multiple myeloma.
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