Healthcare in times of war: The MLL Munich Leukemia Laboratory supports the "Help for Ukrainian Hematology Patients" network, a global initiative for the hematological care of patients in Ukraine. As part of the project, blood or bone marrow samples from Ukraine are sent to the MLL on a weekly basis and the senders receive the results free of charge within a few days. So far, 1200 samples and over 4800 different analyses have been collected.

In the early 2020s, there were hardly any intensive cancer therapies such as allogeneic hematopoietic stem cell transplants or corresponding paediatric programs in Ukraine. At least six local treatment centers performed autologous hematotherapy methods, and some hospitals are members of the European LeukemiaNet (ELN). Most Ukrainian patients with hematologic diseases were still being treated outside the country or not "state of the art" in 2021. In this context, the ELN and the Worldwide Network of Blood & Marrow Transplantation (EBMT) were asked to help establish allogeneic stem cell transplantation programs for adults in the country, among other things.

Since then, hospital visits and the establishment of a telemedicine program have been carried out under the constant leadership of Prof. Dietger Niederwieser (Leipzig) before the Russian Federation invaded Ukraine in February 2022. As a result, the "Help for Ukrainian Hematology Patients (HUP)" network was founded in view of the immense disruption to Ukrainian healthcare in order to establish sustainable care for haematology patients in Ukraine and to address the most important obstacles to haematotherapy through weekly video conferences, among other things. Since then, the most important international haematology and transplant organizations (ASH, ASCO, EHA, DGHO, ECO and WBMT, EBMT, ASTCT) as well as doctors from many Ukrainian institutions, the local Ministry of Health and the World Health Organization (WHO) have been involved. Subsequently, partner cities, various governments and the EU Commission also support the initiative.

In this context, the MLL Munich Leukemia Laboratory has been responsible for complex leukemia diagnostics since the outbreak of the war. We have now carried out over 1200 samples and over 4800 different analyses and sent the results in English immediately to the centers in Ukraine. Blood and bone marrow samples from all over Ukraine are collected weekly in Kiev and sent by courier to the MLL for cytological, cytogenetic, immunophenotypic and comprehensive molecular genetic analysis. Results are made available to the Ukrainian hospitals within a few hours or days - in all cases at the expense of the MLL.

Overall, the HUP network is committed to patient care at home and abroad, the collection of missing medicines, equipment and supplies and the improvement of hematological diagnostics. Other tasks include the establishment of a European tumor and transplant committee, the maintenance of a donor register and the founding of a national transplant society. The creation of a nationwide emergency plan and the standardization of procedures and processes are also being pursued. The successful allocation of patients to transplant centers in Ukraine and Europe, the delivery of drugs and laboratory equipment, and the weekly tumor board of the EBMT under the direction of Prof. Niederwieser are just some of the special milestones achieved under the most adverse circumstances, which have been made possible by the tireless efforts of the network's numerous partners.

Despite the highly problematic situation on the ground, characterized by war and a lack of medical resources, an exemplary care system for haematological patients has been established thanks to the solidarity of international societies, private sector institutions such as the MLL and dedicated local doctors and officials. The use of new technologies, including telemedicine, is also crucial. It will have to be tested whether this blueprint, which has been tried and tested for more than two years, can also be copied and adapted in other regions with corresponding emergencies.

>> The project was also presented by Prof. Niederwieser as a lecture at the 65th Annual Meeting of the American Society of Hematology ASH in San Diego in December 2023:

https://ash.confex.com/ash/2023/webprogram/Paper185883.html