Disease relapse and infectious complications as the main cause of stem cell transplant failure
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 9
Abstract
Introduction. Hematopoietic stem cell transplantation (HSCT) is an important therapeutic method in hematology, oncology and immunology.Aim. The general overview of the results of HSCT in Bydgoszcz Transplant Center with respect to donor type.Material and methods. Between 2003 to June 2013, a total number of 241 of hematopoietic stem cell transplantations were performed in Department of Pediatric Hematology and Oncology, Collegium Medicum, Bydgoszcz, including 130 allogeneic (51 family and 60 unrelated donors) and 111 autologous HSCT. In 20 patients, more than 1 transplantation was performed.Results. A total of 143/221 (64.7%) patients were alive at the end of the follow-up. Among auto-HSCT patients 29/102 (28.5%) has died due to disease relapse/progression (n = 25, i.e. 24.6%) or transplant-related complications (n = 4, i.e. 3.9%). TRM included transplant toxicity (n = 3) or infections (n = 1). Among allo-HSCT patients 49/119 (41.2%) has died due to disease relapse/progression (n = 19, i.e. 15.8%) or transplant-related complications (n = 30, i.e. 25%). TRM included infections (n = 18, i.e. 60%), GVHD (n = 7, i.e. 23.3%) or transplant toxicity (n = 5, i.e. 16.7%). The median follow-up of survivors estimated by Kaplan-Meier method was 5.8 years. Probability of overall survival (pOS) for all patients was 0.61 ± 0.03. pOS after allo-HSCT was 0.56 ± 0.06, and after auto-HSCT was 0.65 ± 0.06. pOS after matched family donor HSCT was 0.66 ± 0.07 and after alternative donor HSCT 0.48 ± 0.07. With respect to unrelated donors, pOS was 0.49 ± 0.09 for 10/10 HLA-matched donors (MUD-HSCT), 0.52 ± 0.11 for 9/10 HLA-matched donors and 0.20 ± 0.18 for 8/10 HLA-matched donors.Conclusion. Disease relapse and infectious complications are the main cause of allogeneic stem cell transplant failure, while disease relapse is the main cause of autologous transplant failure.
Authors and Affiliations
Jan Styczyński, Robert Dębski, Anna Krenska, Krzysztof Czyżewski, Ninela Irga, Magdalena Szalewska, Elżbieta Adamkiewicz-Drożyńska, Marcin Płonowski, Maryna Krawczuk-Rybak, Tomasz Ociepa, Monika Pogorzała, Mariusz Wysocki
Keywords
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