Immunohematopoietic stem cell transplantation in Cape Town: A ten-year outcome analysis in adults

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dc.contributor.authorWood, L.
dc.contributor.authorHaveman, J.
dc.contributor.authorJuritz, J.
dc.contributor.authorWaldmann, H.
dc.contributor.authorHale, G.
dc.contributor.authorJacobs, P.
dc.date.accessioned2011-05-15T16:16:31Z
dc.date.available2011-05-15T16:16:31Z
dc.date.issued2009
dc.description.abstractBACKGROUND AND OBJECTIVES: Immunohematopoietic stem cell transplantation has curative potential in selected hematologic disorders. Stem cell transplantation was introduced into South Africa in 1970 as a structured experimental and clinical program. In this report, we summarize the demography and outcome by disease category, gender, and type of procedure in patients older than 18 years of age who were seen from April 1995 to December 2002. PATIENTS AND METHODS: This retrospective analysis included 247 individuals over 18 years of age for whom complete data were available. These patients received grafts mostly from peripheral blood with the appropriate stem cell population recovered by apheresis. RESULTS: Patient ages ranged from 20 to 65 years with a median age of 42 years. There were 101 females and 146 males. There were no withdrawals and 63% survived to the end of the study. At 96 months of follow-up, a stable plateau was reached for each disease category. Median survival was 3.3 years (n=6, 14.6%) for acute lymphoblastic anemia, 3.1 years (n=44, 18%) for acute myeloid leukemia, 2.8 years (n=47, 19%) for chronic granulocytic leukemia, 2.8 years (n=71, 29%) for lymphoma, 1.5 years (n=23, 9%) for myeloma, 1.43 years (n=10, 4%) for aplasia, and 1.4 years (n=38, 15%) for a miscellaneous group comprising less than 10 examples each. Multivariate analysis showed that only diagnosis and age had a significant impact on survival, but these two variables might be interrelated. There was no significant difference in outcome by source of graft. CONCLUSION: The results confirm that procedures carried out in a properly constituted and dedicated unit, which meets established criteria and strictly observes treatment protocols, generate results comparable to those in a First World referral center. Low rates of transplant-related mortality, rejection and graft-versus-host disease are confirmed, but the benefits cannot be extrapolated outside of academically oriented and supervised facilities.
dc.description.versionArticle
dc.identifier.citationHematology/ Oncology and Stem Cell Therapy
dc.identifier.citation2
dc.identifier.citation2
dc.identifier.issn16583876
dc.identifier.urihttp://hdl.handle.net/10019.1/13820
dc.subjectalemtuzumab
dc.subjectbortezomib
dc.subjectbusulfan
dc.subjectcarmustine
dc.subjectchlorambucil
dc.subjectcladribine
dc.subjectcyclizine
dc.subjectcyclophosphamide
dc.subjectcytarabine
dc.subjectdexamethasone
dc.subjectepipodophyllotoxin
dc.subjectepirubicin
dc.subjectetoposide
dc.subjectfludarabine
dc.subjectgemtuzumab ozogamicin
dc.subjectgranulocyte colony stimulating factor receptor
dc.subjecthydroxyurea
dc.subjectimatinib
dc.subjectlymphocyte antibody
dc.subjectmelphalan
dc.subjectmethylprednisolone
dc.subjectmetoclopramide
dc.subjectnavelbine
dc.subjectparacetamol
dc.subjectphenobarbital
dc.subjectrituximab
dc.subjectserotonin antagonist
dc.subjectunindexed drug
dc.subjectvalaciclovir
dc.subjectvincristine
dc.subjectacute granulocytic leukemia
dc.subjectacute lymphoblastic leukemia
dc.subjectadult
dc.subjectaged
dc.subjectapheresis
dc.subjectaplasia
dc.subjectarticle
dc.subjectblood
dc.subjectcancer radiotherapy
dc.subjectcell population
dc.subjectchronic granulocytic leukemia
dc.subjectdemography
dc.subjectdisease classification
dc.subjectdrug dose titration
dc.subjectdrug megadose
dc.subjectfebrile neutropenia
dc.subjectfemale
dc.subjectgender
dc.subjectgraft failure
dc.subjecthairy cell leukemia
dc.subjecthematopoietic stem cell transplantation
dc.subjectHodgkin disease
dc.subjecthuman
dc.subjectimmunosuppressive treatment
dc.subjectlymphoma
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmyeloma
dc.subjectnausea and vomiting
dc.subjectneutropenia
dc.subjectoutcome assessment
dc.subjectoverall survival
dc.subjectretrospective study
dc.subjectskin lymphoma
dc.subjectsurvival
dc.subjecttreatment duration
dc.subjectvirus infection
dc.subjectAdult
dc.subjectAged
dc.subjectFemale
dc.subjectGraft Survival
dc.subjectGraft vs Host Disease
dc.subjectHematologic Neoplasms
dc.subjectHematopoietic Stem Cell Transplantation
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectRetrospective Studies
dc.subjectSouth Africa
dc.subjectSurvival Rate
dc.subjectTime Factors
dc.subjectTransplantation Conditioning
dc.subjectTransplantation, Homologous
dc.subjectTreatment Outcome
dc.subjectYoung Adult
dc.titleImmunohematopoietic stem cell transplantation in Cape Town: A ten-year outcome analysis in adults
dc.typeArticle
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