Haematopoietic Stem Cell Transplantation: A Single Centre Experience from Army Hospital (Research & Referral), New Delhi, India

• Published in: Blood 2008-11, Vol.112 (11), p.4377-4377
• Main Authors: Nair, Velu, Sharma, Ajay, Das, Satyaranjan, Mishra, Deepak Kumar, Kotwal, Jyoti, Dabas, Ridhima, Nair, Vivek, Khetarpal, Anil, Sen, Alok, Mathew, O P
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V112.11.4377.4377

Haematopoietic stem cell transplantation {HSCT} is being offered as a definitive mode of therapy in various hematological disorders. We present retrospective data of 113(39 females) patients who underwent HSCT in High Efficiency Particulate Air {HEPA} filtered unit. Of these, 36 underwent Autologous HSCT {Auto-HSCT} comprising of 15 patients for Acute Myeloid Leukemia {AML} and 21 for Multiple Myeloma{MM}.). The indications for Allogenic HSCT {Allo-HSCT} were Chronic Myeloid Leukemia{CML}-19;AML-17; Thalassaemia Major-18;Myelodysplastic Syndrome{MDS}-01; Acute Lymphoblastic Leukemia-09,; Severe Aplastic Anemia {SAA}-09; Pure red cell Aplasia-02 and Juvenile Myelomonocytic Leukemia-02. All allogeneic recipients, received stem cells from HLA matched siblings. The conditioning was done with standard busulfan-cyclophosphamide (Bu-Cy) based protocols for leukemia; fludarabine, cyclophosphamide & Anti-Thymocyte globulin {ATG} for SAA; Bu-Cy-ATG for thalassemia and melphalan for MM. The mean age was 25 years (2–60). The median cell dose was 6.0×108MNC/Kg (2.2–11.7). The median day of engraftment for neutrophils (ANC > 500/mm3) was on day 11(7–22) and for platelets (Plt >20,000/mm3) it was on day 13(8–37). Peripheral blood was used as a source of stem cells for all patients who underwent Auto-HSCT, except for two patients where bone marrow was also harvested in addition, to achieve adequate cell dose. For Allo-HSCT, peripheral blood was used for 47 patients and bone marrow for 29 patients. Both bone marrow and cord blood was used in one patient for Allo-HSCT. Analysis of All-HSCT: Analysis revealed 13/77(16.88%) patients developed sinusoidal obstruction syndrome {SOS}. Of these 06 had severe SOS and 04 of them died. 5/77(6.49%) patients developed hemorrhagic cystitis who responded to conservative management. Incidence of grade III/IV acute graft versus host disease {GVHD} was 10/77 (12.98%), of which 4 patients died. Of these, 3 were Thalassemia Major patients who underwent bone marrow stem cell transplant {BMSCT} while the remaining were hematological malignancies (CML-04; AML-01; ALL-02) who underwent peripheral blood stem cell transplant {PBSCT}. Also, 20/77 (25.97%) patients were noted to have chronic GVHD (Limited-12 & Extensive-08). Interestingly there was strikingly higher incidence of chronic GVHD in the PBSCT group i.e. 19/47 (40.43%) as compared to BMSCT group where it was only 1/30 (3.34%). This was found to be statistically significant (p