Virtual HCT consults and NMDP HLA Today speed time to HCT
A case study with Tennessee Oncology, CHI Memorial and the Sarah Cannon Transplant and Cellular Therapy Program in Tennessee
Care teams at Tennessee Oncology and CHI Memorial in Chattanooga, Tenn., faced a situation like many other hematology/oncology practices. When a patient needed an allogeneic hematopoietic cell transplantation (HCT) consultation and human leukocyte antigen (HLA) typing, the Sarah Cannon Transplant and Cellular Therapy Program at TriStar Centennial Medical Center was more than two hours away in Nashville, Tenn.
That delayed an HCT consultation and HLA typing for weeks as the patient finished inpatient induction chemotherapy. This, in turn, could cause a delay in time to transplant.
However, a two-pronged solution existed: virtual HCT consults while the patient received induction therapy and HLA typing through NMDP℠ HLA Today.
The referral and HLA typing process before virtual consults and NMDP HLA Today
After a diagnosis of a disease like an acute leukemia, Tennessee Oncology physicians in Chattanooga would admit a patient to CHI Memorial for induction chemotherapy.
Once the patient completed the six to eight weeks of induction therapy, they returned to Tennessee Oncology a week or two later. If the patient was a potential candidate for HCT, Tennessee Oncology would start the referral process, typically to Sarah Cannon in Nashville.
HLA typing for HCT was not available at Tennessee Oncology or CHI Memorial. That meant initial HLA typing and a preliminary related or unrelated donor search did not occur until the Sarah Cannon team saw the patient in Nashville.
William Donnellan, MD, and Bertrand Anz III, MD, from Tennessee Oncology and physicians at Sarah Cannon recognized there were missed opportunities to get the patient on the path to HCT sooner.
The referral and HLA typing process with virtual consults and NMDP HLA Today
Dr. Donnellan, Dr. Anz and Sarah Cannon HCT physicians established telemedicine HCT consults with a referral shortly after diagnosis. A Sarah Cannon HCT physician and the patient have the virtual consult while the patient receives induction therapy.
The teams also began using the NMDP HLA Today program, which removes barriers to HLA typing at the hematology/oncology practice. With HLA Today, patients and family members receive HLA typing at no cost and begin the related and unrelated donor search process early.
It’s been a great opportunity for patients. Patients often sit in the hospital for a month or two getting their initial treatments. [The virtual consults and HLA Today] fit perfectly so patients can get their consult, they can get their typing, and by the time they get out of the hospital, a lot of the things that were delaying [patients] afterwards has already been done.
WILLIAM DONNELLAN, MD
Hematology Physician Tennessee Oncology – Chattanooga
When a Tennessee Oncology physician identifies a patient as a potential transplant candidate, they put in a nursing communication order for HLA typing through HLA Today. A nurse from CHI Memorial uses an HLA Today kit to swab the patient’s cheek and send the sample to NMDP for HLA typing.
Tennessee Oncology and Sarah Cannon receive the typing results from NMDP, and Sarah Cannon uses the HLA Today sample as the initial HLA typing. The Sarah Cannon lab conducts confirmatory typing from a blood draw.
In addition, if Tennessee Oncology or Sarah Cannon want family members HLA typed, NMDP sends HLA Today kits to the selected family members and emails the results to Tennessee Oncology and/or Sarah Cannon. HLA typing family members early means the physicians know right away if the patient has a related donor match.
I'm thankful it exists. This has been one of the easiest and most successful items we've incorporated into our comprehensive workflow. I think [HLA Today] is a huge benefit to patients.
HANNAH WALKER, BSN, RN, OCN
Oncology Nurse Manager CHI Memorial
Together, the telemedicine consult with a Sarah Cannon HCT physician and early HLA typing through NMDP HLA Today considerably speed up the patient’s treatment plan, allowing the patient to potentially avoid the toxicities of additional rounds of chemotherapy or relapse.
A patient can move seamlessly onto the next treatment step after finishing induction therapy—shaving up to eight weeks off the previous timeline from patient diagnosis to the initial HCT consult at Sarah Cannon. This increases the likelihood a patient can undergo transplant at the optimal time.
It has greatly sped things up. [HLA Today] decreases the time in getting patients to transplant. If we didn’t have HLA Today, we would need to wait until they get discharged [after induction therapy] and make a 2- to 3-hour drive to the center to get typed. In our experience, we get a 6- to 8-week lead time on our normal process for referrals.
JEREMY PANTIN, MD
HCT Physician Sarah Cannon Transplant and Cellular Therapy Program
Get started with NMDP HLA Today
NMDP HLA Today is available for any patient in the United States newly diagnosed with a condition for which HCT may be indicated. The program is especially beneficial for hematology/oncology practices that do not have a process to HLA type patients before referral. It is available to hematology/oncology practices—and patients—at no cost.
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