Allogeneic stem cell Transplant in Hematological Disorders: A Decade of Experience

Salman  Arif; Natasha  Ali; Usman  Shaikh; Salman  Adil; Hamzah  Jehanzeb

doi:10.18502/ijhoscr.v18i4.16759

Salman Arif Department of Oncology, Aga Khan University Hospital, Karachi, Pakistan
Natasha Ali Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
Usman Shaikh Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
Salman Adil Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
Hamzah Jehanzeb Medical Student, Medical College, Aga Khan University Karachi, Pakistan

DOI: https://doi.org/10.18502/ijhoscr.v18i4.16759

Keywords: Allogeneic stem cell transplant; Graft–vs-host disease (GvHD); Transplant-related mortality; Hematological diseases

Abstract

Background: Allogeneic hematopoietic cell transplantation (allo-HCT) is a complex procedure with the potential to provide curative treatment for various hematological disorders. This study aims to evaluate the outcomes of allo-HCT in hematological diseases and identify significant complications in a single-center setting.

Materials and Methods: We conducted a retrospective analysis of 180 patients with hematological diseases who underwent allo-HCT between January 2011 and December 2021. Key outcomes, including indications for transplantation, overall survival, engraftment time, relapse rates, graft-versus-host disease (GVHD), and transplant-related mortality (TRM) were assessed.

Results: The most common indications for allo-HCT were benign hematological diseases, particularly aplastic anemia, and thalassemia major. Despite the majority of patients receiving fully matched transplants, Acute GVHD was observed in 30% of the cohort. Graft failure occurred in 13 patients, with primary and secondary graft failure rates of 1.6% and 5.5%, respectively. Sepsis emerged as the primary cause of non-relapsed mortality at day 100 and beyond. The overall survival rate in this study was 62%, with 79% of patients disease-free on their last visit.

Conclusion: This study provides valuable insights into the treatment strategies and patient care of allo-HCT for hematological disorders by offering a comprehensive overview of multiple relevant outcomes. The findings underscore the significance of addressing complications and risk factors associated with allogeneic transplantation, including GVHD and infections. Future research should focus on further optimizing transplantation techniques to minimize complications and enhance patient survival.