Ignazio Majolino1, Dosti Othman2, Attilio Rovelli1, Dastan Hassan2, Luqman Rasool2, Michele Vacca1, Nigar Abdalrahman2, Chra Abdullah2, Zhalla Ahmed2, Dlir Ali2, Kosar Ali2, Chiara Broggi1, Cinzia Calabretta1, Marta Canesi1, Gloria Ciabatti1, Claudia Del Fante1, Elisabetta De Sapio1, Giovanna Dore1, Andrea Frigato1, Marcela Gabriel1, Francesco Ipsevich1, Harem Kareem2, Dana Karim2, Rosa Leone1, Tavan Mahmood2, Annunziata Manna1, Maria Speranza Massei1, Andrea Mastria1, Dereen Mohammed2, Rebar Mohammed2, Khoshnaw Najmaddin2, Diana Noori2, Angelo Ostuni1, Angelo Palmas1, Marco Possenti1, Ali Qadir2, Giorgio Real1, Rebwar Shrif2, Caterina Valdatta1, Stefania Vasta1, Marta Verna1, Mariangela Vittori1, Awder Yousif2, Francesco Zallio1, Alessandro Calisti1 , Sergio Quattrocchi3 and Corrado Girmenia1.
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describe the entire process leading to the start-up of a hematopoietic
stem cell transplantation center at the Hiwa Cancer Hospital, in the
city of Sulaymaniyah, Kurdistan Iraqi Region. This capacity building
project was funded by the Italian Development Cooperation Agency and
implemented with the support of the volunteer work of Italian
professionals, either physicians, nurses, biologists and technicians.
The intervention started in April 2016, was based exclusively on
training and coaching on site, that represent a significant innovative
approach, and led to a first autologous transplant in June 2016 and to
the first allogeneic transplant in October. At the time of reporting, 9
months from the initiation of the project, 18 patients have been
transplanted, 15 with an autologous and 3 with an allogeneic graft. The
center at the HCH represents the first transplantation center in
Kurdistan and the second in wide Iraq. We conclude that international
development cooperation may play an important role also in the field of
high-technology medicine, and contribute to improved local centers
capabilities through country to country scientific exchanges. The
methodology to realize this project is innovative, since HSCT experts
are brought as volunteers to the center(s) to be started, while
traditionally it is the opposite, i.e. the local professionals to be
trained are brought to the specialized center(s).
|Table 1. Areas of the Hiwa Hospital that were explored in the preliminary assessmen. Hinari is a programme set up by WHO together with major publishers, that enables low- and middle- income countries to gain access to one of the world's largest collections of biomedical and health literature (http://www.who.int/hinari/en/).|
|Figure 1. Schematic representation of the capacity building project at the Hiwa Cancer Hospital. Agenzia Italiana per la Cooperazione allo Siluppo Italian Agency for Development Cooperation (AICS).|
|Table 2. List of the subjects/titles covered by the initial educational meeting entitled “Hematopoietic Stem Cell Transplantation at Hiwa Hospital” held April 3-12, 2016. At the end of the course, all participants received a certificate and a copy of the power-point slides presented by the speakers.|
|Table 3. Protocols and procedures edited, verified and approved at the HCH by the joint efforts of Italian and Kurdish team. They are divided into 4 groups by the field of application. Some of them are accompanied by attachments as forms, calculation sheets, or algorithms to facilitate the use.|
|Table 4. Autologous transplantation: characteristics of the patients, time to engraftment and survival.|