title: High-dose chemotherapy with autologous stem cell transplantation is feasible and safe in a regional hospital. A 6-year experience in southern Switzerland.
abstract: High-dose therapy with bone marrow (BM) or blood stem cell (BSC) support is a high-technology technique usually administered in specialized tertiary centers. The use of BSC has made this technique simpler and accessible also to smaller hospitals. We retrospectively analyzed the data of patients with lymphoma, leukemia and other tumors who received high-dose therapy and BM or BSC transplantation in our district hospital, looking at the type of procedure performed, complications, use of growth factors, and progression-free and overall survival. A total of 40 patients were transplanted over 6 years. No procedure-related deaths and no permanent organ toxicities were seen. The use of BSC brought about a great reduction in the duration of hospital stay, septic complications and transfusion of blood components. For patients with lymphoma (n = 20) the probabilities of progression-free survival and of overall survival at 2 years are 48% (95% C.I. 28-68%) and 68% (95% C.I. 46-84%), respectively. Based on these data, we believe that ABMT and BSC transplantation are feasible and safe in a peripheral hospital when the appropriate human and technical conditions are present. Treatment outcome is then comparable to that of specialized centers.
authors.affiliation: Servizio Oncologico Ticinese, Ospedale San Giovanni, Bellinzona, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Regazzoni
authors.forename: G
authors.initials: G
authors.lastname: Marini
authors.forename: A
authors.initials: A
authors.lastname: Grob
authors.forename: A
authors.initials: A
authors.lastname: Pedrazzini
authors.forename: A
authors.initials: A
authors.lastname: Goldhirsch
authors.forename: D
authors.initials: D
authors.lastname: Castelli
authors.forename: F
authors.initials: F
authors.lastname: Cavalli
authors.forename: M
authors.initials: M
authors.lastname: Ghielmini
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D006085:Graft Survival; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D013557:Switzerland; D014182:Transplantation, Autologous; D016896:Treatment Outcome