International Journal of Hematology and Oncology
2023, Vol 33, Num 4 Page(s): 175-183
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HEMATOPOIETIC STEM CELL TRANSPLANTATION IN ADULTS: HACETTEPE HEMATOLOGY EXPERIENCE 2001-2004
Salih AKSU1, Hakan GÖKER1, İbrahim C. HAZNEDAROĞLU1, Yahya BÜYÜKAŞIK1, Nilgün SAYINALP1, Ebru KOCA1, Osman İ. ÖZCEBE1
Hacettepe Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Hematoloji Ünitesi, ANKARA
Keywords: Bone Marrow transplantation, Hematopoietic stem cell, Graft versus Host Disease
Introduction of the bone marrow transplantation for therapeutic purposes began in 1939 for an aplastic anemia patient, because of golden poisoning. First succesful bone marrow transplantation was done to an ALL patient, from six sibling donors. After the discovery of HLA typing, the numbers of bone marrow transplantation proceduders have increased. Clinical and molecular properties of bone marrow transplantation have been improved with the reduced mortality rate and increased success. By using growth factors; namely G-CSF and GM-CSF, the collection of peripheral blood stem cells, especially for autologous stem cell transplantation has gotten better. For the allogeneic transplantation, donor selection should be performed very carefully. We must type the donor’s HLA and check for the viral serology and physical condition. For the transplant patient, we have to make tests for all of the above and to know about his/her illness history and performance status. There are numerous conditioning regimens for hematopoietic stem cell transplantation. They are mainly radiation based regimens; non-radiation based regimens and non myeloablative or reduced intensity regimens. After hematopoietic stem cell transplantation, lots of complications are evident. Among them, infections, GVHD and organ toxicity of conditioning regimen drugs are the most important complications. The aım of this cross-sectional retrospective study is to analyse the patients that hematopoietic stem cell transplantation had been performed. During this period, we have performed hematopoietic stem cell transplantation to 27 patients, (10 men and 17 women). Median age of the patients was 34 (range; 18-54). The transplant procedure was autologous for 6 (22.2%) patients and allogeneic for 21 (78.8%) patients. One patient has been made myeloablative conditioning, other regimens were reduced intensity conditioning regimen. Median neutrophil engraftment was 10 days (3 - 15 days), median thrombocyte engraftment has 9 days (0-17 days). Infectious complications were lower than expected in our patients were in hepafiltered, positive airway pressure and laminar air flow rooms, this probably reduced especially some airborne fungal infections, such asaspergillosis. After 37 months following time, 8 (29.6%) of 27 patients has died, 5 (%18.5) patients disease has relapsed, 2 patients has lost to the follow up, 11 patient is alive without disease. The time of follow up is median 14 months (1-37 months). Estimated disease free survival for 32 months is %37, and estimated overall survival for 32 months is %61.8 with Kaplan-Meier analysis.
Salih AKSU1, Hakan GÖKER1, İbrahim C. HAZNEDAROĞLU1, Yahya BÜYÜKAŞIK1, Nilgün SAYINALP1, Ebru KOCA1, Osman İ. ÖZCEBE1
Hacettepe Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Hematoloji Ünitesi, ANKARA
Keywords: Bone Marrow transplantation, Hematopoietic stem cell, Graft versus Host Disease
Introduction of the bone marrow transplantation for therapeutic purposes began in 1939 for an aplastic anemia patient, because of golden poisoning. First succesful bone marrow transplantation was done to an ALL patient, from six sibling donors. After the discovery of HLA typing, the numbers of bone marrow transplantation proceduders have increased. Clinical and molecular properties of bone marrow transplantation have been improved with the reduced mortality rate and increased success. By using growth factors; namely G-CSF and GM-CSF, the collection of peripheral blood stem cells, especially for autologous stem cell transplantation has gotten better. For the allogeneic transplantation, donor selection should be performed very carefully. We must type the donor’s HLA and check for the viral serology and physical condition. For the transplant patient, we have to make tests for all of the above and to know about his/her illness history and performance status. There are numerous conditioning regimens for hematopoietic stem cell transplantation. They are mainly radiation based regimens; non-radiation based regimens and non myeloablative or reduced intensity regimens. After hematopoietic stem cell transplantation, lots of complications are evident. Among them, infections, GVHD and organ toxicity of conditioning regimen drugs are the most important complications. The aım of this cross-sectional retrospective study is to analyse the patients that hematopoietic stem cell transplantation had been performed. During this period, we have performed hematopoietic stem cell transplantation to 27 patients, (10 men and 17 women). Median age of the patients was 34 (range; 18-54). The transplant procedure was autologous for 6 (22.2%) patients and allogeneic for 21 (78.8%) patients. One patient has been made myeloablative conditioning, other regimens were reduced intensity conditioning regimen. Median neutrophil engraftment was 10 days (3 - 15 days), median thrombocyte engraftment has 9 days (0-17 days). Infectious complications were lower than expected in our patients were in hepafiltered, positive airway pressure and laminar air flow rooms, this probably reduced especially some airborne fungal infections, such asaspergillosis. After 37 months following time, 8 (29.6%) of 27 patients has died, 5 (%18.5) patients disease has relapsed, 2 patients has lost to the follow up, 11 patient is alive without disease. The time of follow up is median 14 months (1-37 months). Estimated disease free survival for 32 months is %37, and estimated overall survival for 32 months is %61.8 with Kaplan-Meier analysis.
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