Introduction to the importance of infections in haematological malignancies and CCRE scope
Haematological malignancies account for 7000 new cases, 3000 deaths and 0.8% of Australian hospital separations per year [Cancer series 23, Aust. Institute Health & Welfare]. Haematopoietic stem cell (marrow and blood) transplantation (HSCT) is a major advance in therapy for acute leukaemia. Over 1000 transplants are performed each year, at a cost of at least $150,000 each. Cure is achieved in most “good risk” patients, but only after severe immuno-suppression and with long-term social and psychological sequelae. Infections are the major cause of preventable morbidity, mortality and greatly inflate costs.
Practicable strategies for prevention, earlier diagnosis, novel therapies, decision support to minimize infection and improve outcomes, and their ethical implications, need to be systematically evaluated and incorporated into routine management so that the health benefits of antileukaemic therapies are optimised.
The NSW Bone Marrow Transplant (BMT) Network was established in 2002 to standardize management and facilitate clinical research. It provides the framework for the multi-disciplinary research and training program of this CCRE and combines expertise in epidemiology, microbiology, therapeutics, decision support, occupational health, health ethics, medicine & nursing. Outcomes will be directly applicable to other vulnerable patient groups.
