A retrospective observational study of autologous peripheral blood stem-cell transplantation and long-term survival outcomes - An institutional experience

A retrospective observational study of autologous peripheral blood stem-cell transplantation and long-term survival outcomes - An institutional experience

Autologous peripheral blood stem cell transplantation (PBSCT) has been employed in patients with various haematological and non-haematological malignancies. The present retrospective study aimed to examine the clinical efficacy and overall long-term survival outcomes of the patients who underwent autologous PBSCT. The clinical data of 49 patients with various haematological and non-haematological malignancies from the Department of Haematology of SMS Hospital from April 2015 to March 2021 were retrospectively analysed. The median age of our patients was 41.5 years. Among all indications, relapsed hodgkins lymphoma (10, 20.4%) and multiple myeloma (27, 55.1%) were reported to be high. The average engraftment was observed to be 11 days with no post-operative complications. The average follow-up period was 2.5 years with a mortality rate of 8.16% (4). Overall, a total of 43 (87.75%) patients showed a complete response with a relapse rate of 12.24% (6). In conclusion, autologous PBSCT can be an effective treatment option with good clinical efficacy, and long term survival outcomes. Our results are comparable to those of many national and international published reports. Overall, the results suggest that with improved management of conditioning-related toxicities and infections, it is possible to develop PBSCT programs in third-world countries and achieve outcomes comparable to those in the international data.

___

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin [Internet]. 2021 May 1 [cited 2021 Oct 19];71(3):209–49. Available from: https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21660
  • 2. Hungria VT de M, Chiattone C, Pavlovsky M, Abenoza LM, Agreda GP, Armenta J, et al. Epidemiology of Hematologic Malignancies in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study. https://doi.org/101200/JGO1900025. 2019 Nov 27;5:1–19.
  • 3. Keykhaei M, Masinaei M, Mohammadi E, Azadnajafabad S, Rezaei N, Saeedi Moghaddam S, et al. A global, regional, and national survey on burden and Quality of Care Index (QCI) of hematologic malignancies; global burden of disease systematic analysis 1990–2017. Exp Hematol Oncol 2021 101 [Internet]. 2021 Feb 8 [cited 2021 Oct 19];10(1):1–15. Available from: https://ehoonline.biomedcentral.com/articles/10.1186/s40164-021-00198-2
  • 4. O A, R M. Mobilization of peripheral blood stem cells. Transfus Apher Sci [Internet]. 2007 Oct [cited 2021 Oct 19];37(2):179–85. Available from: https://pubmed.ncbi.nlm.nih.gov/17980665/
  • 5. Nishimura KK, Barlogie B, van Rhee F, Zangari M, Walker BA, Rosenthal A, et al. Long-term outcomes after autologous stem cell transplantation for multiple myeloma. Blood Adv. 2020 Jan 28;4(2):422–31.
  • 6. Saad A, Lamb LS. Ex vivo T-cell depletion in allogeneic hematopoietic stem cell transplant: past, present and future. Bone Marrow Transplant 2017 529 [Internet]. 2017 Mar 20 [cited 2021 Oct 19];52(9):1241–8. Available from: https://www.nature.com/articles/bmt201722
  • 7. Melve GK, Ersvaer E, Eide GE, Kristoffersen EK, Bruserud Ø. Peripheral Blood Stem Cell Mobilization in Healthy Donors by Granulocyte Colony-Stimulating Factor Causes Preferential Mobilization of Lymphocyte Subsets. Front Immunol. 2018 May 2;0(MAY):845.
  • 8. JR W, NS M, R B, Z W, KA S, D J, et al. Long-term survival and late deaths after allogeneic hematopoietic cell transplantation. J Clin Oncol [Internet]. 2011 Jun 1 [cited 2021 Oct 19];29(16):2230–9. Available from: https://pubmed.ncbi.nlm.nih.gov/21464398/
  • 9. Peyrade F, Gastaud L, Ré D, Pacquelet-Cheli S, Thyss A. Treatment decisions for elderly patients with haematological malignancies: a dilemma. Lancet Oncol. 2012 Aug 1;13(8):e344–52.
  • 10. Alves A de SBM, Bataglia FB, Conterno L de O, Segato R, Payão SLM. Epidemiological and cytogenetic profiles of patients with hematological malignancies and their relationship with aging. Hematol Transfus Cell Ther. 2018 Jul 1;40(3):200–6.
  • 11. Sant M, Allemani C, Tereanu C, De Angelis R, Capocaccia R, Visser O, et al. Incidence of hematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood [Internet]. 2010 Nov 11 [cited 2021 Oct 22];116(19):3724–34. Available from: http://ashpublications.org/blood/article-pdf/116/19/3724/1489994/zh804510003724.pdf
  • 12. Poon EYL, Wong E, Goh WL, Hong J, Wong V, Quah D, et al. Hematological malignancies in the adolescent and young adult (AYA) population in Singapore. https://doi.org/101200/JCO20203815_suppl.e13630. 2020 May 25;38(15_suppl):e13630–e13630.
  • 13. MM H, E R, TA S, MS H. Pattern of hematological malignancies in adolescents and young adults in Bangladesh. Cancer Epidemiol [Internet]. 2017 Dec 1 [cited 2021 Oct 22];51:109–12. Available from: https://pubmed.ncbi.nlm.nih.gov/29121606/
  • 14. Visani G, Lemoli R, Tosi P, Martinelli G, Testoni N, Ricci P, et al. Use of peripheral blood stem cells for autologous transplantation in acute myeloid leukemia patients allows faster engraftment and equivalent disease-free survival compared with bone marrow cells. Bone Marrow Transplant 1999 245 [Internet]. 1999 Sep 8 [cited 2021 Oct 22];24(5):467–72. Available from: https://www.nature.com/articles/1701920
  • 15. Arslan Ö, Moog R. Mobilization of peripheral blood stem cells. Transfus Apher Sci [Internet]. 2007 Oct 1 [cited 2021 Oct 22];37(2):179–85. Available from: http://www.trasci.com/article/S1473050207001115/fulltext
  • 16. WI B, PJ M, B S, R C, SJ F, R N, et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers. N Engl J Med [Internet]. 2001 Jan 18 [cited 2021 Oct 22];344(3):175–81. Available from: https://pubmed.ncbi.nlm.nih.gov/11172139/
  • 17. Russell NH, Pacey S. Economic evaluation of peripheral blood stem cell transplantation for lymphoma. Lancet [Internet]. 1992 Nov 21 [cited 2021 Oct 22];340(8830):1290. Available from: http://www.thelancet.com/article/014067369292992O/fulltext
  • 18. Reconstitution of human hematopoietic function with autologous cryopreserved circulating stem cells - PubMed [Internet]. [cited 2021 Oct 22]. Available from: https://pubmed.ncbi.nlm.nih.gov/2868909/
  • 19. Linker CA. Autologous stem cell transplantation for acute myeloid leukemia. Bone Marrow Transplant. 2003 May;31(9):731–8.
  • 20. Linker CA, Damon LE, Ries CA, Navarro WA, Case D, Wolf JL. Autologous stem cell transplantation for advanced acute myeloid leukemia. Bone Marrow Transplant. 2002;29(4):297–301. 21. Use of peripheral blood stem cells for autologous transplantation in acute myeloid leukemia patients allows faster engraftment and equivalent disease-free survival compared with bone marrow cells | Bone Marrow Transplantation [Internet]. [cited 2021 Oct 22]. Available from: https://www.nature.com/articles/1701920
  • 22. Wierenga PK, Weersing E, Dontje B, de Haan G, van Os R. Differential role for very late antigen-5 in mobilization and homing of hematopoietic stem cells. Bone Marrow Transplant. 2006 Dec;38(12):789–97.
  • 23. Höglund M, Brune M, Sallerfors B, Ahlgren T, Billström R, Hedenus M, et al. More efficient mobilisation of peripheral blood stem cells with HiDAC + AMSA + G-CSF than with mini-ICE + G-CSF in patients with AML. Bone Marrow Transplant. 2003 Dec;32(12):1119–24.
  • 24. Blum V, Heini AD, Novak U, Taleghani BM, Baerlocher GM, Leibundgut K, et al. Hematopoietic stem cell remobilization with vinorelbine and filgrastim in AML. Bone Marrow Transplant. 2017 May 1;52(5):786–8.
  • 25. S S, N S, R D, Q Z, D A, P E, et al. BEAM or BUCYVP16-conditioning regimen for autologous stem-cell transplantation in non-Hodgkin’s lymphomas. Bone Marrow Transplant [Internet]. 2019 Oct 1 [cited 2021 Oct 22];54(10):1553–61. Available from: https://pubmed.ncbi.nlm.nih.gov/30718797/
  • 26. JB P, C G, R S, D O, J S, A C, et al. LACE-conditioned autologous stem cell transplantation for relapsed or refractory Hodgkin’s lymphoma: treatment outcome and risk factor analysis in 67 patients from a single centre. Bone Marrow Transplant [Internet]. 2007 Jan [cited 2021 Oct 22];39(1):41–7. Available from: https://pubmed.ncbi.nlm.nih.gov/17115062/
  • 27. T P, C G, A H, R S, H V der L, D B, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med [Internet]. 1995 Dec 7 [cited 2021 Oct 23];333(23):1540–5. Available from: https://pubmed.ncbi.nlm.nih.gov/7477169/
  • 28. Gupta, Gokarn A, Rajamanickam D, Punatar S, Thippeswamy R, Mathew L, et al. Lomustine, cytarabine, cyclophosphamide, etoposide – An effective conditioning regimen in autologous hematopoietic stem cell transplant for primary refractory or relapsed lymphoma: Analysis of toxicity, long-term outcome, and prognostic factors. J Cancer Res Ther [Internet]. 2018 Jul 1 [cited 2021 Oct 22];14(5):926. Available from: https://www.cancerjournal.net/article.asp?issn=0973-1482;year=2018;volume=14;issue=5;spage=926;epage=933;aulast=Gupta
  • 29. J O, F M, M P, A F, S R, M G, et al. A Comparison of the Conditioning Regimens BEAM and FEAM for Autologous Hematopoietic Stem Cell Transplantation in Lymphoma: An Observational Study on 1038 Patients From Fondazione Italiana Linfomi. Biol Blood Marrow Transplant [Internet]. 2018 Sep 1 [cited 2021 Oct 22];24(9):1814–22. Available from: https://pubmed.ncbi.nlm.nih.gov/29857196/
  • 30. Rajamanickam D, Gokarn A, Gupta A, Punatar S, Thippeswamy R, Bagal B, et al. LACE - an Effective Conditioning Regimen for Lymphoma Patients Undergoing Autologous Transplant- Analysis of Outcomes and Prognostic Factors. Blood. 2014 Nov 14;124(21):3979.
  • 31. C G, B G, N M, D SG, DC L, M T, et al. Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era. J Clin Oncol [Internet]. 2010 Sep 20 [cited 2021 Oct 23];28(27):4184–90. Available from: https://pubmed.ncbi.nlm.nih.gov/20660832/
  • 32. Hahn L, Lim H, Dusyk T, Sabry W, Elemary M, Stakiw J, et al. BeEAM conditioning regimen is a safe, efficacious and economical alternative to BEAM chemotherapy. Sci Reports 2021 111 [Internet]. 2021 Jul 7 [cited 2021 Oct 22];11(1):1–9. Available from: https://www.nature.com/articles/s41598-021-93516-x
  • 33. 405-Autologous conditioning protocol BEAM (carmustine etoposide cytarabine melphalan) | eviQ [Internet]. [cited 2021 Oct 22]. Available from: https://www.eviq.org.au/haematology-and-bmt/blood-and-marrow-transplant/autologous/405-autologous-conditioning-protocol-beam-carmust
  • 34. Colita A, Colita A, Bumbea H, Croitoru A, Orban C, Lipan LE, et al. LEAM vs. BEAM vs. CLV Conditioning Regimen for Autologous Stem Cell Transplantation in Malignant Lymphomas. Retrospective Comparison of Toxicity and Efficacy on 222 Patients in the First 100 Days After Transplant, On Behalf of the Romanian Society for Bone Marrow Transplantation. Front Oncol. 2019 Sep 10;0:892.
  • 35. Galieni P, Troiani E, Bigazzi C, Mazzotta S, Ruggieri M, Pezzoni V, et al. Modified BEAM as conditioning regimen for lymphoma patients undergoing autologous hematopoietic stem cell transplantation. Bone Marrow Transplant 2018 531 [Internet]. 2017 Oct 2 [cited 2021 Oct 22];53(1):91–3. Available from: https://www.nature.com/articles/bmt2017206
  • 36. Mancardi G, Sormani MP, Muraro PA, Boffa G, Saccardi R. Intense immunosuppression followed by autologous haematopoietic stem cell transplantation as a therapeutic strategy in aggressive forms of multiple sclerosis: https://doi.org/101177/1352458517742532 [Internet]. 2017 Nov 10 [cited 2021 Oct 22];24(3):245–55. Available from: https://journals.sagepub.com/doi/10.1177/1352458517742532
  • 37. Mohammadi R, Aryan A, Omrani MD, Ghaderian SMH, Fazeli Z.

    Autologous Hematopoietic Stem Cell Transplantation (AHSCT): An Evolving Treatment Avenue in Multiple Sclerosis

    . Biol Targets Ther [Internet]. 2021 Mar 2 [cited 2021 Oct 22];15:53–9. Available from: https://www.dovepress.com/autologous-hematopoietic-stem-cell-transplantation-ahsct-an-evolving-t-peer-reviewed-fulltext-article-BTT
  • 38. Hamerschlak N, Rodrigues M, Moraes DA, Oliveira MC, Stracieri ABPL, Pieroni F, et al. Brazilian experience with two conditioning regimens in patients with multiple sclerosis: BEAM/horse ATG and CY/rabbit ATG. Bone Marrow Transplant 2010 452 [Internet]. 2009 Jul 6 [cited 2021 Oct 22];45(2):239–48. Available from: https://www.nature.com/articles/bmt2009127
  • 39. Saccardi R, Freedman M, Sormani M, Atkins H, Farge D, Griffith L, et al. A prospective, randomized, controlled trial of autologous haematopoietic stem cell transplantation for aggressive multiple sclerosis: a position paper. Mult Scler [Internet]. 2012 [cited 2021 Oct 22];18(6):825. Available from: /labs/pmc/articles/PMC3389500/
  • 40. Cohen JA, Baldassari LE, Atkins HL, Bowen JD, Bredeson C, Carpenter PA, et al. Autologous Hematopoietic Cell Transplantation for Treatment-Refractory Relapsing Multiple Sclerosis: Position Statement from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2019 May 1;25(5):845–54.
  • 41. Das J, Sharrack B, Snowden JA. Autologous Haematopoietic Stem Cell Transplantation in Multiple Sclerosis: a Review of Current Literature and Future Directions for Transplant Haematologists and Oncologists. Curr Hematol Malig Rep [Internet]. 2019 Apr 15 [cited 2021 Oct 21];14(2):127. Available from: /labs/pmc/articles/PMC6510794/
  • 42. Al Hamed R, Bazarbachi AH, Malard F, Harousseau J-L, Mohty M. Current status of autologous stem cell transplantation for multiple myeloma. Blood Cancer J 2019 94 [Internet]. 2019 Apr 8 [cited 2021 Oct 19];9(4):1–10. Available from: https://www.nature.com/articles/s41408-019-0205-9
  • 43. M B, JJ L, JD G, P R, C S, A A, et al. Intravenous busulfan and melphalan as a conditioning regimen for autologous stem cell transplantation in patients with newly diagnosed multiple myeloma: a matched comparison to a melphalan-only approach. Biol Blood Marrow Transplant [Internet]. 2013 Jan [cited 2021 Oct 25];19(1):69–74. Available from: https://pubmed.ncbi.nlm.nih.gov/22897964/
  • 44. JJ L, MV M, J M-L, C G, J de la R, L R, et al. Busulfan 12 mg/kg plus melphalan 140 mg/m2 versus melphalan 200 mg/m2 as conditioning regimens for autologous transplantation in newly diagnosed multiple myeloma patients included in the PETHEMA/GEM2000 study. Haematologica [Internet]. 2010 [cited 2021 Oct 25];95(11):1913–20. Available from: https://pubmed.ncbi.nlm.nih.gov/20663944/
  • 45. Muta T, Miyamoto T, Kamimura T, Kanda Y, Nohgawa M, Ueda Y, et al. Significance of Salvage Autologous Stem Cell Transplantation for Relapsed Multiple Myeloma: A Nationwide Retrospective Study in Japan. Acta Haematol [Internet]. 2018 Feb 1 [cited 2021 Oct 22];139(1):35–44. Available from: https://pubmed.ncbi.nlm.nih.gov/29339642/
  • 46. M C, M J, A H, K L, CM M, HR J, et al. The Karolinska experience of autologous stem-cell transplantation for lymphoma: a population-based study of all 433 patients 1994-2016. Exp Hematol Oncol [Internet]. 2019 Mar 18 [cited 2021 Oct 25];8(1). Available from: https://pubmed.ncbi.nlm.nih.gov/30923643/
  • 47. Hematopoietic Stem-Cell Transplantation in the Developing World: Experience from a Center in Western India [Internet]. [cited 2021 Oct 25]. Available from: https://www.hindawi.com/journals/jo/2015/710543/
  • 48. Mazza P, Palazzo G, Minoia C, Amurri B, Pisapia G. Autologous and allogeneic stem cell transplant in Jehovah’s Witnesses: a single-center experience on 22 patients. Bone Marrow Transplant 2016 517 [Internet]. 2016 Mar 7 [cited 2021 Oct 25];51(7):1002–3. Available from: https://www.nature.com/articles/bmt201629
  • 49. Thoennissen GB, Görlich D, Bacher U, Aufenberg T, Hüsken A-C, Hansmeier AA, et al. Autologous Stem Cell Transplantation in Multiple Myeloma in the Era of Novel Drug Induction: A Retrospective Single-Center Analysis. Acta Haematol [Internet]. 2017 Apr 1 [cited 2021 Oct 22];137(3):163–72. Available from: https://www.karger.com/Article/FullText/463534
  • 50. 1467-Autologous conditioning protocol LACE (lomustine cytarabine CYCLOPHOSPHamide etoposide) | eviQ [Internet]. [cited 2021 Oct 22]. Available from: https://www.eviq.org.au/haematology-and-bmt/blood-and-marrow-transplant/autologous/1467-autologous-conditioning-protocol-lace-lomust
  • 51. Arslan O, Moog R. Mobilization of peripheral blood stem cells. Transfus Apher Sci [Internet]. 2007 Oct [cited 2021 Oct 22];37(2):179–85. Available from: https://pubmed.ncbi.nlm.nih.gov/17980665/
  • 52. Thippeswamy R, Mathew L, Bhosale B, Kumar N, Kannan S, Joshi A, et al. LACE: A conditioning regimen for patients with lymphoma undergoing autologous transplant. https://doi.org/101200/jco20112915_suppl6591. 2011 May 20;29(15_suppl):6591–6591.
  • 53. BL Z, J Z, QD L, YZ L, YL Z, RR G, et al. Retrospective analysis of the efficacy and influencing factors of autologous hematopoietic stem cell transplantation for multiple myeloma. Artif Organs [Internet]. 2019 Oct 1 [cited 2021 Oct 22];43(10):1028–34. Available from: https://pubmed.ncbi.nlm.nih.gov/30972806/
  • 54. Attal M, Harousseau J-L, Facon T, Guilhot F, Doyen C, Fuzibet J-G, et al. Single versus Double Autologous Stem-Cell Transplantation for Multiple Myeloma. http://dx.doi.org/101056/NEJMoa032290 [Internet]. 2009 Oct 7 [cited 2021 Oct 21];349(26):2495–502. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa032290
  • 55. Palumbo A, Cavallo F, Gay F, Di Raimondo F, Ben Yehuda D, Petrucci MT, et al. Autologous Transplantation and Maintenance Therapy in Multiple Myeloma. http://dx.doi.org/101056/NEJMoa1402888 [Internet]. 2014 Sep 3 [cited 2021 Oct 22];371(10):895–905. Available from: https://www.nejm.org/doi/full/10.1056/nejmoa1402888
Journal of Experimental and Clinical Medicine-Cover
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1980
  • Yayıncı: Ondokuz mayıs Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy

Kübra BAKİ ERİN, Turhan ARAN, Asım ÖREM

THE EFFECTS OF SYSTEMIC INFLAMMATORY INDICES, LACTATE, AND BLOOD GAS PARAMETERS ON DRUG-RESISTANT AND DRUG-NONRESISTANT EPILEPSY

Tuba EKMEKYAPAR

Minimally invasive transthoracic repaired Morgagni hernia: A case repor

Caner İŞEVİ, Mehmet PİRZİRENLİ, Berk Caner ÖTEN, Burçin ÇELİK

The effect of the basal frontal QRS-T angle on disease severity and mortality in Covid-19 patients

Gülçin PATMANO, Bedri Caner KAYA, Mehmet TERCAN, Tuğba BİNGÖL TANRIVERDİ, Firdevs Tugba BOZKURT

Association between Subfatin level and Preeclampsia: case-control study

Caner KOSE, Büşra KÖRPE, Fahri Burçin FIRATLIGİL, Yıldız AKDAŞ REİS, Gulay BALKAS, Büşra ŞAHİN, Yaprak USTUN

The Herbal Supplement Induces G2 Arrest and Apoptosis in A549 Cells In Vitro

Melek YÜCE, Cagri GUMUSKAPTAN

Mineral composition, in-vivo hematinic and antioxidant potential of Jatropha gossypiifolia n-hexane root extract in hemolytic anemic rats

Benjamin Ogunma GABRİEL, Macdonald IDU

Investigating the role of microRNAs, inflammation, and Helicobacter pylori in Epstein-Barr virus associated gastric cancer

Amin EBADİ, Reyhaneh RASİZADEH, Parisa SHİRİ AGHBASH, Nima HEMMAT, Hossein BANNAZADEH BAGHİ

Exploring pearls and pitfalls in the diagnosis of rickettsia among children: Mini-review and case report

Basuki SUPARTONO, Hutri MAHARDİKA

Evaluation of oral cavity pathologies in pediatric dentistry patients: A 10-year retrospective study

Sefa ÇOLAK, Yunus BALEL, Ahmet ALTAN, Nihat AKBULUT