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. 2025 Jul 5;15(1):24089.
doi: 10.1038/s41598-025-10061-7.

Advancing the pathway to allogeneic hematopoietic stem cell transplantation through a physician-nurse coordinator system in patients with acute leukemia

Chidapa Auepisit  1   2 , Weerapat Owattanapanich  1   2 , Smith Kungwankiattichai  1   2 , Chutima Kunacheewa  1   2 , Suparat Atakulreka  1   2 , Kamolchanok Kulchutisin  2 , Nawapotch Donsakul  3   4
Affiliations

Advancing the pathway to allogeneic hematopoietic stem cell transplantation through a physician-nurse coordinator system in patients with acute leukemia

Chidapa Auepisit et al. Sci Rep. .

Abstract

Acute leukemia is an aggressive hematologic malignancy with a historically poor prognosis. The introduction of allogeneic hematopoietic stem cell transplantation (allo-HSCT) has substantially improved patient outcomes, offering the potential for a cure. However, prolonged preparation time for allo-HSCT can increase the risk of disease relapse or complications from consolidation chemotherapy. To address this issue, we established a physician‒nurse coordinator system to streamline and organize the preparation of patients and donors for allo-HSCT. In this single-center study, we combined prospective and historical cohorts. Adult leukemia patients (aged 18 years or older) who underwent allo-HSCT at Siriraj Hospital, Bangkok, Thailand, were enrolled. The primary aim was to compare the timing and rate of transplantation before and after the implementation of the physician‒nurse coordinator system. Between January 1, 2018, and February 1, 2024, 105 patients were enrolled. Patients diagnosed after August 1, 2021, were categorized into the physician-nurse coordinator group, resulting in 61 patients in the conventional group and 44 in the physician‒nurse coordinator group. The median (Q1, Q3) time from diagnosis to transplantation was significantly shorter in the physician‒nurse coordinator group than in the conventional group (9.0 [6.0, 14.0] months vs. 13.0 [7.5, 19.5] months; P = 0.029). Similarly, the time from diagnosis to complete preparation was significantly shorter (7.0 [5.0, 12.8] months vs. 11.0 [6.5, 17.0] months; P = 0.022). However, improvements in the transplantation rate within 6 months, relapse during transplant preparation, and post-transplantation outcomes did not reach statistical significance. Implementing a physician‒nurse coordinator system significantly reduced the time from diagnosis to allo-HSCT in acute leukemia patients. Our findings suggest that such coordinated care models could be valuable in optimizing the management of acute leukemia patients eligible for transplantation.

Keywords: Acute leukemia; Allogeneic hematopoietic stem cell transplantation; Physician‒nurse coordinator.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Informed consent: Informed consent was obtained from participants in the prospective cohort. Research ethics: This study was approved by the Ethics Committee for Research in Human Subjects of the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (COA no. Si 902/2022). The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013).

Figures

Fig. 1
Fig. 1
Roles of the physician–nurse coordinator.
Fig. 2
Fig. 2
Study profile.
See this image and copyright information in PMC

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