title: [Reasons for not carrying out stem cell transplantation in patients referred to a transplant unit].
abstract: OBJECTIVE
  Although indications of stem cell transplantation (SCT) are increasing, a transplant may not be performed in all planned cases for several reasons. Our objective was to investigate the reasons for which SCT was not performed in patients referred to a transplant unit.
  
  
  METHODS
  Pretransplant data of 129 patients consecutively referred to a transplant unit between December 1999 and November 2002 were collected. Frequency and causes of non transplantation were analyzed. Transplanted and non transplanted patient's characteristics were compared.
  
  
  RESULTS
  In 119 out of 129 patients, an autologous SCT was indicated and in 10 of them an allogeneic SCT was planned. Mean (SD) age was 46 (14) years (range, 13-69) and 69 (53.5%) were males. One hundred eighteen patients had malignant hematological diseases and 11 had solid tumours. Sixty-one patients showed complete response and 68 had a partial response. At the time of the analysis, 93 SCT had been performed in 90 (69.8%) patients. Autologous SCT was performed in 81 patients (two SCT in one patient) and allogeneic SCT in 10 (two in one patient). Two (1.5%) patients were still awaiting SCT. An SCT was not performed in 37 (28.7%) patients. Causes of non transplantation included: in 12 (32.5%) cases, relapse and/or progression at the time the SCT had been planned; in 12 (32.5%), delay or change in the therapeutic decision; in 9 (24%), poor mobilization; and in 4 (11%), patient's refusal. When delay in SCT was excluded from the analysis, the frequency of no transplant was 19.4%. In 21 (57%) patients of the non-SCT group, peripheral stem cells were previously collected by apheresis. Both groups (SCT and non-SCT) were comparable regarding patients' and disease characteristics except for a more advanced age in the non-SCT group (51 [12] vs 44 [14] years, p<0.005) and status of the disease at the pretransplant visit.
  
  
  CONCLUSIONS
  The frequency of not performing an SCT in patients referred to a SCT unit was considerable. Relapses and disease progression and poor mobilization were the main causes for it. Delay was also a relatively common cause.
authors.affiliation: Servicio de Hematología, Institut Català d'Oncologia, Unitat Hematooncològica, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Sancho
authors.forename: Josep María
authors.initials: JM
authors.lastname: Ribera
authors.forename: Albert
authors.initials: A
authors.lastname: Oriol
authors.forename: Montserrat
authors.initials: M
authors.lastname: Batlle
authors.forename: Alonso
authors.initials: A
authors.lastname: Flores
authors.forename: Lluís
authors.initials: L
authors.lastname: Rodríguez
authors.forename: Marta
authors.initials: M
authors.lastname: Torrabadella
authors.forename: Fuensanta
authors.initials: F
authors.lastname: Millá
authors.forename: Evarist
authors.initials: E
authors.lastname: Feliu
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation / Q000706:statistics & numerical data*