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264 Help for Ukrainian Hematology Patients (HUP) – a Global Initiative Supporting the Establishment of Hematology Centers and Hematopoietic Cell Transplantation Programs in a Time of War

Program: Oral and Poster Abstracts
Type: Oral
Session: 903: Health Services and Quality Improvement – Myeloid Malignancies: From Blood to Bombs: Identifying and Addressing Barriers to Care for Myeloid Malignancies
Hematology Disease Topics & Pathways:
Clinical Practice (Health Services and Quality), Diversity, Equity, and Inclusion (DEI) , Study Population, Human
Saturday, December 9, 2023: 3:15 PM

Sergiy Klymenko1*, Irina Korenkova2*, Oleksandr Lysytsia3*, Menachem Bitan, MD, PhD4*, Olena Lukianets, MD5*, Jan M. Zaucha6*, Joannis Mytilineos7*, Andreas Hochhaus, MD8, Mats Heyman9, Francois Guilhot, MD10*, Natacha Bolanos11*, Roman Kuts, MD12*, Hildegard T. Greinix, MD13, Isabel sanchez-Ortega14*, Mickey Boon Chai Koh, MD, PhD15*, Bohdan Medvediev16*, Susan Landgraf17*, Rüdiger Hehlmann, MD 18, Mahmoud Aljurf, MD19*, Torsten Haferlach, MD, PhD20, Arnold Ganser21, Anna Maria Sureda Balari, MD, PhD22, Damiano Rondelli, MD23* and Dietger W. Niederwieser, MD24

1Feofaniya Hospital, Kyiv, UKR
2Kyiv Bone Marrow Transplantation Center, 119 Peremohy avenue, Kyiv, kyiv, Ukraine
3National Specialized Children's Hospital "Ohmatdyt", Kyiv, Ukraine
4Meuhedet HMO and The Hebrew University of Jerusalem, Jerusalem, Israel
5Clinical Center of Oncology, Hematology, Transplantology and Palliative Care of Cherkasy Oblast Council,, Cherkasy, Ukraine
6Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland
7Zentrales Knochenmarkspenderregister Deutschlands (ZKRD), Ulm, Germany
8Department Hematology and Oncology, Klinik für Innere Medizin II, Jena, Germany
9Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
10University of Poitiers, Poitiers, France, FRA
11Lymphoma coalition, Madrid, Spain
12Ukrainian Bone Marrow Donor Registry, Kyiv, Ukraine
13Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
14EBMT executive Office, Barcelona, Spain
15St George's University Hospitals, London, United Kingdom
16Kyiv Bone Marrow Transplantation Center, Kyiv, Ukraine
17St. Georg Hospital, Leipzig, Germany
18ELN-Foundation, Weinheim, Germany
19King Faisal Specialist Hospital & Research Centre, Oncology (Section of Adult Haematolgy/BMT) – Riyadh, Saudi Arabia, Riyadh, Saudi Arabia
20MLL Munich Leukemia Laboratory, Munich, Germany
21Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
22Clinical Hematology Department, Institut Català d’Oncologia, Hospital Duran i Reynals, IDIBELL, Univerisitat de Barcelona, Barceloma, Spain
23Division of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL
24University of Leipzig, Leipzig, Germany


In 2021 most of the Ukrainian patients with hematological diseases and in need of allogeneic hematopoietic cell transplantation (HCT) were treated outside the country with governmental funding or not treated. Only 147 autologous and 6 allogeneic HCT in adults (75 and 33 in children, respectively) in a country of 44 million population were reported to the Worldwide Network for Blood ad Marrow Transplantation (WBMT). In the same year, the European Leukemia Net (ELN) and the WBMT were approached to support or establish sustainable HCT programs for adults in the country.


After a site visit at different Ukrainian hospitals in November 2021, daily supervisory telemedicine was initiated in January 2022, immediately before the war in February affected daily life and the existing healthcare in the country. With the mission to establish sustainable care for hematology patients, representatives from major international hematology (ASH, ASCO, EHA, DGHO, ECO), transplant organizations (WBMT, EBMT, ASTCT) and physicians from multiple Ukrainian institutions formed the HUP (Help for Ukrainian Hematology Patients) network with the participation of the Ministry of Health and the World Health Organization (WHO). On weekly video conference meetings, the need and solutions were discussed starting with a list of patients in need for treatment.


Patients were allocated according to their wishes in Ukrainian Hospitals or abroad with the help of EBMT, WBMT, EHA and ECO. In the same time, the daily grand rounds were pursued to help Ukrainian physicians to treat patients with blood disorders remaining in the country. While many drugs were already available, a list of drugs not available and not registered in the Ukraine was created. Medicines were donated from different sources including sister cities, governments and EU commission. In parallel, standard operating procedures were provided to the institutions. Despite war and during bombing, autologous HCT activities continued and allogeneic HCT programs for adults initiated. To ensure highest quality, the EBMT instituted a routine tumor board with global experts to discuss the indication for treatments and, if this was not possible in the country (e.g. CAR-T cell, bispecific antibody treatment), transfer to transplant centers abroad was organized. In order to identify unrelated transplant donors, the Ukrainian unrelated donor search and registry was supported. The cooperation of the Ukrainian institutions with regard to exchange of drugs and other needs was impressive and a transplant society (UABMT) for adult and pediatric patients with the participation of all Ukrainian centers was founded. The volume of allogeneic HCT in adult patients increased rapidly to 45 patients from related, unrelated and haploidentical donors at the BMT center in Kyiv, in the Cherkhasy Regional Hospital in Cherkhasy, and in the Children Hospital “Ohmatdyt” in Kyiv (Table 1) in the same year 2022. Autologous HSCT also increased in these and other hospitals in Lviv and Kyiv. The activities are now continuously increasing and will reach an even higher number in 2023. It rapidly became apparent that with HCT also the other hematological infrastructure had to be improved. While basic hematological diagnostics were available in the Ukraine, a possibility to have the most sophisticated diagnostics was created with the help of ASH and ASTCT. Blood or marrow samples from the whole country are now transferred weekly to the Munich Leukemia Lab (MLL) laboratory to be tested for cytological, cytogenetical, immunophenotyping, and molecular analyses and results made available to Ukrainian hospitals within a few days free of charge. Up to now samples from 341 patients from all Ukraine have been analyzed at diagnosis and at different time points during their treatment.


Despite the hostile environment, intense cooperation and support by international societies, private institutions, WHO, together with the personal involvement of the committed local physicians and the Ministry of Health were able to provide an example on how to establish a sustainable healthcare system for hematological patients in a low resource country in extreme distress. This effort represents a model that by using solidarity and new technologies may greatly impact other countries affected by socio-economic, or conflict challenges.

SK, IK and MA, TH, AG, AS, DR, DN contributed equally

Disclosures: Zaucha: Gilead: Honoraria; Novartis: Honoraria; MSD: Research Funding; BMS: Research Funding; Takeda: Honoraria; Abbvie: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria; Janssen: Honoraria. Hochhaus: Bristol Myers Squibb: Consultancy, Research Funding; Pfizer: Research Funding; Incyte: Research Funding; Takeda: Consultancy, Research Funding; Novartis: Consultancy, Research Funding. Haferlach: MLL Munich Leukemia Laboratory: Current Employment, Other: Equity Ownership. Sureda Balari: Takeda: Consultancy, Speakers Bureau; Kite: Consultancy, Speakers Bureau. Rondelli: Vertex: Other: Steering Committee.

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