autologous blood and marrow transplantation - Blog Science ...

360 Chapter 6: Breast Cancer
DIFFERENCES BETWEEN EUROPE AND NORTH AMERICA
Apart from the difference in the choice of the number of positive lymph nodes
for high-risk operable breast cancer and the use of the combination of peripheral
blood progenitor cells and autologous bone marrow, other differences exist
between Europe and North America. First, the policy of treating patients outside a
clinical trial seems less accepted in Europe, 7
partly due to the fact that insurance
coverage in Europe generally is provided by the treating center and not by the
patients themselves.
In many countries, insurance is still not required and this allows an easier
accrual of patients in trials as in the case of other solid tumors.
A common accreditation policy is not yet well established in Europe, and the
EBMT together with ISHAGE published some guidelines (minimum number of
patients treated per year, laboratory and blood bank facilities, etc.) which, it is
hoped, will become mandatory for each European center in the near future. So far
in Europe, high-dose chemotherapy and hematopoietic rescue has not been
considered standard therapy for breast carcinoma of any stage, 9
and the policy of
treating patients outside clinical trials should be discouraged.
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