Newly established stem cell transplant program: 100 days follow-up of patients and its comparison with published Indian literature.
BACKGROUND
Hematopoietic progenitor stem cell transplantation (HPSCT) is used as a standard treatment option to improve outcome in hematological and nonhematological disorders. It is important for new HPSCT program to look at its patient outcome data and compare it with the published data to evaluate the efficacy of program.


OBJECTIVE
The aim was to compile and collate the patient outcome data of HPSCT and compare with published reports.


METHODS
Patient demographics, indications, stem cell harvest by apheresis, dose collected, infusion, engraftment, and follow-up data were collected from hospital information system from 2010 to 2013 in a tertiary care hospital. HPSCs were mobilized with granulocyte colony-stimulating factor, and harvests were done on the 5(th) day. Engraftment was decided for neutrophil when counts were 0.5 × 10(9)/L and for platelets when counts were 20 × 10(9)/L on two consecutive days without any transfusion support.


RESULTS
There were 133 harvests for 95 patients with various disorders; multiple myeloma was most common in autologous and acute lymphoblastic leukemia in allogeneic group. One hundred harvests were done for autologous and 33 for allogeneic HPSCT. In autologous group, of 66 patients, 60 (90.9%) received stem cell infusion at median dose of 4.63 × 10(6) CD34(+) cells/kg. Similarly, in allogeneic group, of 29 patients, 27 (93.10%) received infusion at median dose of 5.8 × 10(6) CD34(+) cells/kg. 58 (96.9%) patients and 25 (92.6%) engrafted in autologous and allogeneic group, respectively. The median time for neutrophils engraftment was 11 days in autologous group and 12 days in allogeneic group. The median time for platelet engraftment was 11.5 days in autologous group and 13 days in allogeneic group. The 100-day survival rate was 95% (n = 57) in autologous group and 77.8% (n = 21) in allogeneic group.


CONCLUSIONS
This data analysis shows reasonably good results of HPSCTs with majority of patients surviving at 100-day follow-up.
Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Aseem Kumar
AK
Tiwari
Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Dinesh
D
Arora
Department of Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Ravi C
RC
Dara
Department of Molecular Genetics and Immunology, Medanta - The Medicity, Gurgaon, Haryana, India.
Pranav
P
Dorwal
Department of Medical and Hemato-oncology, Medanta - The Medicity, Gurgaon, Haryana, India.
Nitin
N
Sood
Department of Paediatric Medical and Hemato-oncology, Medanta - The Medicity, Gurgaon, Haryana, India.
Ruchira
R
Misra
Department of Medical and Hemato-oncology, Medanta - The Medicity, Gurgaon, Haryana, India.
Sunil Kumar
SK
Gupta
Laboratory Services and Transfusion Medicine, Medanta - The Medicity, Gurgaon, Haryana, India.
Vimarsh
V
Raina
Department of Medical and Hemato-oncology, Medanta - The Medicity, Gurgaon, Haryana, India.
Ashok Kumar
AK
Vaid
Follow-up; hematopoietic progenitor stem cell transplants; mortality; peripheral blood stem cells; stem cell transplant program; survival; transplant
JAMA. 2010 Apr 28;303(16):1617-24
20424252
Bone Marrow Transplant. 2005 Aug;36(3):199-204
15937512
Bone Marrow Transplant. 1996 Sep;18(3):501-5
8879609
Bone Marrow Transplant. 1996 May;17(5):703-8
8733685
Leuk Lymphoma. 2009 Sep;50(9):1434-41
19603344
Bone Marrow Transplant. 1998 Dec;22(12):1145-51
9894716
Natl Med J India. 2010 Nov-Dec;23(6):330-5
21561042
Blood. 2008 Mar 15;111(6):2962-72
18332230
Blood. 2000 Jun 15;95(12):3702-9
10845900
Bone Marrow Transplant. 2002 Apr;29(8):639-46
12180107
Blood. 2008 Oct 15;112(8):3036-47
18583566
Br J Haematol. 1996 Dec;95(4):715-23
8982051
Am J Hematol. 2007 Jun;82(6):463-72
17266054
J Clin Oncol. 1999 Mar;17(3):806-12
10071270
Ann Hematol. 2011 Nov;90(11):1317-28
21409382
Clin Lymphoma Myeloma Leuk. 2013 Feb;13(1):32-41
23085487
Semin Hematol. 1999 Oct;36(4 Suppl 7):95-103
10595758
Biol Blood Marrow Transplant. 2014 Sep;20(9):1262-73
24816581
Blood. 1996 Oct 1;88(7):2794-800
8839878
Blood. 2012 Jul 12;120(2):468-72
22517895
J Hematother. 1996 Jun;5(3):213-26
8817388
Bone Marrow Transplant. 2008 Aug;42 Suppl 1:S81-S84
18724312
Lancet Oncol. 2000 Dec;1:227-34
11905640
J Clin Oncol. 2000 Sep 15;18(18):3319-20
10986066
Natl Med J India. 2013 Jan-Feb;26(1):6-11
24066986
Bone Marrow Transplant. 1997 Jan;19(1):9-13
9012925
Blood. 2002 Oct 1;100(7):2374-86
12239145
Transplant Proc. 2012 May;44(4):922-4
22564586
Blood. 1995 Mar 15;85(6):1659-65
7888684
N Engl J Med. 2001 Jan 18;344(3):175-81
11172139