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On August 2, the Centers for Medicare & Medicaid (CMS) released the FY2020 Inpatient Prospective Payment System (IPPS) final rule that includes payment policy for chimeric antigen receptor T-cell (CAR-T) therapy. The American Society for Transplantation and Cellular Therapy (ASTCT) has been working closely with CMS to improve reimbursement for CAR-T therapy and the data the agency collects on its delivery to assure appropriate patient access to this lifesaving therapy. Despite our advocacy efforts, ASTCT is disappointed in the agency’s final payment policy as it did not significantly improve the payment policy for FY 2020 nor did it position the agency ...
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By Mikaela VanMoorleghem, FACT Education and Training Coordinator FACT-SBTMO Joint Accreditation Program Launched in Brazil Approximately 70 representatives of bone marrow transplant centers attended the FACT-SBTMO Accreditation Program Workshop on July 31, 2019; an initiative that is the result of the partnership between the Brazilian Society of Bone Marrow Transplant (SBTMO) and the Foundation for the Accreditation of Cellular Therapy.  The meeting clarified the requirements and the operational dynamics of the accreditation process for Brazilian cell therapy transplant centers. As Carlos Bachier and Phyllis Warkentin of the FACT Global Accreditation ...
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August heralds the beginning of the end for summer. Children start heading back to school. The weather begins to turn crisp. Days get shorter. Leaves start showing hints of red and yellow – very soon they will detach from the stems that have nourished them and then wither away, only to be replaced by new leaves the following spring. A patient once poignantly compared this time of the year to transplant – the end of summer was like the onset of conditioning regimen when there was less sunshine in his life, followed by the "100 days" of fall and winter – but he was hopeful he would see spring again and subsequently enjoy many summers. He considered his stem ...
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Harmonization of Busulfan Plasma Exposure Units (BPEU): A Community-Initiated Consensus Statement Attendees Jitesh D Kawedia, BSPharm, PhD, R.Ph Clinical Pharmacy Specialist The University of Texas MD Anderson Cancer Center Wednesday, September 11, 2019 1pm PST/2pm CST/3 pm EST This event is open to all healthcare professionals for members and nonmembers of ASTCT Registration. Mark your calendar and reserve your seat for this webinar here . You will receive a confirmation e-mail along with a link to access the webinar on the day of the journal club presentation We look forward to your attendance! For additional questions regarding the ASTCT Pharmacy ...
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Following the successful examples of the international symposia focusing on GVHD and relapse after HCT, this symposium will bring together experts and thought leaders from around the world in the fields of HCT, cellular therapies, and related medical subspecialties. Speakers will discuss mechanisms of toxicities and symptom burden after HCT and cellular therapies, current advances in the field, and best practices to both prevent and treat these toxicities and symptoms. When: October 11-12, 2019 Where: Memorial Sloan Kettering Cancer Center, New York, New York Register her
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In this month’s Pharmacy SIG Literature Update:  Autologous HCT in myeloma patients aged > 75 years, improved outcomes for male germ cell tumors, haploidentical hematopoietic cell and kidney transplantation for hematological malignancies and end-stage renal failure and much more! Literature summaries are provided as information only. Please refer to the original published articles for complete details on study methodology, results and discussion. ***        Must read. Landmark publication that affects practice **           Recommend reading. Secondary paper that adds to literature *             Consider reading. Cursory importance to the practice ...
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To Dr. John Hansen, every patient was special. “Every patient that I’ve known, every patient that I’ve helped … every one of them is a precious experience,” Hansen said in an interview in 2018 . Hansen, 76, died peacefully at his home on July 31 after a battle with pancreatic cancer. Hansen left a huge mark on the bone marrow transplant community, with one of his most notable contributions being the National Marrow Donor Program, now known as Be The Match. He played an integral role in understanding how to find suitable donors for each transplant patient, establishing registries of these donors and started collections of biological samples and data that ...
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Dr. Wesley Miller was quiet at times, but when he did speak, he was worth listening to. “He was an excellent listener,” said Dr. John Bantle, one of Miller’s close friends, and a former colleague at the University of Minnesota. “He was extremely insightful and the definition of integrity. If he got into something, he didn’t do anything halfway. He did it intensively.” Miller passed away peacefully at his home on July 15 at the age of 71 after a battle with cancer. Miller was considered a pioneer at the University of Minnesota for his work in bone marrow and stem cell transplantation. He worked there for more than 40 years and was an early proponent of ...
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On Aug. 8, ASTCT President Navneet Majhail, MD, MS, submitted a letter to the Director of Coverage and Analysis Group at the Centers for Medicare and Medicaid Services Tamara Syrek Jensen, JD. In it, Majhail lauded CMS for their Decision Memo on CAR T-cell Therapy for Cancers. From Majhail's letter:  "The American Society for Transplantation and Cellular Therapy (ASTCT) is very pleased with the recent coverage announcement from The Centers for Medicare and Medicaid Services (CMS) in the Decision Memo for Chimeric Antigen Receptor (CAR) T-cell Therapy for Cancers (CAG- 00451N). The Society appreciates the opportunity to work closely with the Agency on this National ...
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The ASTCT Pharmacy Special Interest Group (SIG) Program Planning and Education Committees have launched the Online Enduring Case Presentations from this year's ASTCT Pharmacists Conference. This joint venture is a benefit provided to those practicing in hematopoietic cell transplant (HCT) who are seeking continuing education, but were unable to attend the 2019 TCT Meetings of ASTCT and CIBMTR or missed the ASTCT Pharmacists Conference. If interested, please see below for more information. Courses (FACT credit available) : Evolving Treatment Options for AML by Dr. Lydia Benitez, PharmD, BCOP How I Treat Steroid-Refractory Acute GVHD by Dr. Amin Alousi, ...
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By Mikaela VanMoorleghem, FACT Education and Training Coordinator Help FACT Design Education Just for YOU   We would like to hear from YOU! FACT wants to provide the education that you need. Please help us develop education that is tailored to fit your needs by filling out this short 3-question survey. Complete the  Education Suggestions  survey. -- Biology of Blood and Marrow Transplantation Publishes Article on FACT Clinical Outcome Review Process The journal Biology of Blood and Marrow Transplantation (BBMT) has electronically published the article, Integration of Publicly Reported Center Outcomes into Standards and Accreditation: ...
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In this month’s Pharmacy SIG Literature Update:  PD-1 blockade with pembrolizumab for classical Hodgkin lymphoma after autologous stem cell transplantation, high-dose bendamustine and melphalan conditioning for patients with multiple myeloma, a mortality analysis of letermovir prophylaxis for CMV and much more! Literature summaries are provided as information only. Please refer to the original published articles for complete details on study methodology, results and discussion. ***        Must read. Landmark publication that affects practice **           Recommend reading. Secondary paper that adds to literature *             Consider reading. Cursory ...
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Updates from CMS ASTCT and the American Society of Hematology had a joint call with members of CMS’ Hospital and Ambulatory Policy Group to reiterate our recommendations to improve payment for CAR-T therapy in FY 2020 and to share our early thinking about how to reimburse equitably for the therapy in FY 2021 and beyond. Dr. Dianna Howard, co-chair of the new ASTCT Government Relations Committee, participated in the call and shared the challenges they are facing at Wake Forest establishing a CAR-T program because of the institution’s concerns about reimbursement. We expect CMS to release the final FY 2020 Inpatient Prospective Payment System rule in early ...
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At academic medical institutions in the USA, July tends to be hectic as they welcome a fresh crop of residents and fellows. Most of our incoming hematology-oncology fellows have not had any exposure to BMT or cell therapy during residency, which is a rather unfortunate reality of the how our current internal medicine training is structured nationwide. Our team provides an “Orientation to BMT/cell therapy” session where we talk about navigating the BMT rotation and managing common issues they may need to address when on call. I take advantage of their naivety by telling them that if they don’t review and sign off on our program SOP’s on time, "our program will ...
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By Akshay Sharma, MBBS -- St. Jude Children's Research Hospital As I was flying over the Rocky Mountains on my late afternoon Delta flight, enjoying the views of the snow-covered peaks and skiing trails below, I did not know that the next few days were going to be one of the most transformative experiences of my transplant career so far. I had been to a few clinical research courses in the past and they all were great and educational in their own unique ways. But none of the one’s that I had attended previously had been in particular career a defining one. As I landed in Salt Lake City Airport and was waiting for some of my course mates to arrive, ...
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By Darren Johnson, PA-C - The Children's Hospital at TriStar Centennial, Sarah Cannon Research Institute I was in a fog, all I could see was darkness although it was the middle of the day, the blinds were open and all the lights in my room were on. The nurses around me were hectic, moving quickly and clearly with purpose. Beside me, my mom was squeezing a bag of IV fluid. I was just trying to keep up, but I was scared and I couldn’t process all the activity. I gathered every bit of energy and focus I had to ask one question: “Am I going to die today?” “NO!” was the resounding answer from my nursing staff (including my mom) and that was enough for me.I ...
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The ASTCT would like to thank Dr. Miguel Perales for all of his work on the ASTCT Practice Guidelines App. Physicians from all over the world are using the app to improve the care provided to transplant patients. The mobile app has been downloaded close to 5,700 times by clinicians in 46 different countries. It was because of Dr. Perales's vision that we were able to launch the app. It is through his efforts, and those of other society volunteers, that we are able to add new tools and information on a regular basis. We also want to thank Seattle Genetics for their continued support of this tool.  Download the app in iTunes:  https://apps.apple.com/us/app/astct-practice-guidelines/id1204871675 ...
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Have you been watching HBO this spring? No we are not talking about Game of Thrones, but something much more pertinent to the cellular transplant community. HBO released a five episode mini-series about the 1986 Chernobyl disaster. If you have not seen it - it's worth watching. It is an accurate and chilling reminder of what can happen as a result of a radiological disaster. In the US since 2001, there has been an intense emphasis on preparing the US for a similar radiological disaster which could result in casualties who could develop Acute Radiation Syndrome and would require care by the members of ASTCT. One organization working to help prepare the nation ...
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We had a major quality incident in June – at our home. It was 9 p.m. on a Wednesday night and we were heading home from Olive Garden after a nice dinner celebrating the last day of school. As my better half was reviewing the schedule for the following day, we realized we had no plan for childcare! We had assumed that our 17-year-old would be available and willing to perform older sisterly duties for a day – that is, keep her two younger brothers safe and fed and prevent a riot by keeping them separated for 10 hours. But she reminded us that she had a full day commitment that Thursday and was not going to be home, and that she had texted us about this a week ...
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ASTCT’s FY2020 IPPS Proposed Rule Response On June 24 th , ASTCT submitted comments to the Centers for Medicare and Medicaid (CMS) on the FY2020 Hospital Inpatient Prospective Payment System (IPPS) proposed rule. ASTCT’s comments respond to both the proposals put forth by CMS as well as the request for comment on certain items. Some of the recommendations ASTCT made to the agency include: ASTCT supports CMS’ proposal to increase the new technology add-on payment (NTAP) for all new technologies, but recommends that the agency increase the percentage from 50 percent to 80 percent rather than 65 percent as proposed for all NTAPs. ASTCT recommends that ...
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