Stem cell transplantation in hematological disorders

Saudi Med J. 2008 Oct;29(10):1484-9

Stem cell transplantation in hematological disorders. A developing country experience-impact of cost considerations

El-Zimaity MM, Hassan EA, Abd El-Wahab SE, Abd El-Ghaffar AA, Mahmoud NA, Elafifi AM, Moussa MM, El-Gohary GM, Hagras MM, Mowafy NM.

10 elsheik Ahmed eldardiry st apt # 303, Golfland Cairo, 11361 Egypt. Tel. +202 22906848/+202 (12) 7460920. Fax. +202 25880592. E-mail: mahazimaity@gmail.com.

OBJECTIVE: To describe the experience in setting up a bone marrow transplant program at Ain Shams University, Cairo, Egypt. METHODS: Sixteen patients were transplanted at Ain Shams University Bone Marrow Transplantation unit from March 2005 to January 2008. RESULTS: Sixteen patients were transplanted with a median age of 25 years. Indications for transplantation were chronic myeloid leukemia, acute myeloid leukemia, aplastic anemia, acute lymphoblastic leukemia, and aggressive lymphoma. Seven donors and 6 patients were positive for cytomegalovirus immunoglobulin G (IgG) antibody (Ab) pretransplant. Only one patient was positive for toxoplasma IgG Ab and another had a high titre for toxoplasma IgM Ab pretransplant. Two donors and 2 recipients were positive for hepatitis B antibody markers; however, none were positive for hepatitis B virus DNA by polymerase chain reaction (PCR). None of the patients or donors were positive for hepatitis C virus via PCR pre-transplant. Acute graft versus host disease (GVHD) was seen in 3 patients, while chronic GVHD was seen in 5 patients. Primary cause of death was recurrence in 2 patients and graft failure in one patient. Thirteen are alive and disease free with a median follow-up of 20 months. CONCLUSION: Although our unit is a relatively new unit, these results are comparable to those achieved in the Western world and cost a mean of US$250,000.

PMID: 18946578 [PubMed - in process]