Atlas of Hematology

Hematopoetic stem celi transplantation activity at a single center: Cerrahpaşa experience
At our institution 94 transplantations have been performed in an 8 year period up to December 2001. Forty-three females and 49 males with ages ranging from 14 to 61 years received 67 allogeneic (allo) and 27 autologous (auto) transplants; 2 patients were transplanted twice. The diagnosis of allo transplants were AML (27 patients-pts), CML (17 pts), ALL (16 pts) and AA (5 pts); those of auto transplants were NHL (13 pts), HD (10 pts), MM (3 pts) and AML (l pt). Of the patients with acute leukemia 69.7% were in first CR and ali but öne of the patients with CML were in first chronic phase. Source of hematopoetic stem cells were bone marrow (BM) in 61.9% (allo 81.5%, auto 14.8%) and peripheral blood (PB) in 38.1% (allo 18.5%, auto 85.2%). Ail donors were HLA-full matched siblings with öne exception. Conditionİng regimens were BU-CY (31 pts), TBI-CY (28 pts) and Flag-lda (öne pî) for leukemia, CY-ATG for AA, CBV for lymphoma and Mel-200 for MM. Median 2.69 x 108 nucieated celIsAg (BM) and 21.7 x 106 CD34 + celIsAg (PB) were infused to allo transplant recipients; 4 patients faiied to engraft and öne patient was inevaluable due to early death. Acute GVHD was observed in 11 patients (16.9% - grade ll-IV in 10.7%) and chronic GVHD was documented in 18 patients (33.9%- extensive in 9.43%). VOD was seen in 8 patients (12.3%). Early response was CR in 91.6% in patienîs wîth leukemia; patients with lymphoma showed a 73.1% response (CR & PR) rate and 23.1% had resistant disease. So far 27.6% of the patients have relapsed ör showed progression and 45.7% have died (disease-related 27.2%, transplant-related 18.5%). At a median follow-up time of 32 months (range 0.6-96) DFS is 50.8% and OS is 53.9% in the allo transplant group. With a shorter follow-up (median 16 months, range 1-65) the same figures for the auto transplant group are 51.9 and 55.5%, respectively, in this cohort overall, OS and DFS are significantly superior in patients with early-stage disease: 71.7% vs. 26.7% in advanced-stage disease for OS and 71.4% vs. 36.8% for DFS, respectively and this trend applies to both transplant groups (p< 0.001 for ali comparisons).

Authors: Zafer Başlar, Teoman Soysal, Burhan Ferhanoğlu, Şeniz Öngören, Ümit Üre, Yıldız Aydın, Birsen Ülkü, Gülten Aktuğlu, Nuran Akman

Keywords:

Year: 2002
Number: 2
Referance No: 21526

Figure 1. Overall survival of patients with leukenia after allogeneic STC according to diagnosis ( Lines represent: CML -- ,ALL and AML).Cumulative proportion of the patients surviving after transplant. Survival was calculated in months after transplant. Each cross represent a patient being alive at that time.Difference in OS between patients with CML and ALL/AML was highly significant(p<0.001).
Figure 2. Overall survival of patients with leukenia after allogeneic SCT according to disease status at transplant (Lines represent: Early-stage--- and advanced-stage).Cumulative proportion of the patients surviving after transplant.Survival was calculated in months after transplant. Each cross represent a patient being alive at that time.Difference in OS between patients transplanted in early stages and advanced stages was highly significant(p<0.001).
Figure 3. Disease-free survival after allogeneic SCT according to diagnosis(Lines represent: CML----,ALL and AML).Cumulative proportion of the patients surviving after transplant.Survival was calculated in months after CR was documented. Each cross represent a patient being alive at the time.Difference in DFS between patients with CML and ALL/AML was highly significant(p<0.001).
Figure 4. Disease-free survival after allogeneic SCT according at transplant(Lines represent: Early-stage--- and advanced-stage).Cumulative proportion of the patients surviving after transplant. Survival was calculated in months after CR was documented.Each cross represent a patient being alive at that time.Difference in DES between patients translanted in early stages and advanced stages was highly significant (p<0.001).
Figure 5. Overall survival of patients with HD and NHL after autologous SCT according to disease status at transplant.(Lines reprecent: Early-stage -- and advanced-stage).Cumulative proportion of the patients surviving after transplant. Survival was calculated in months after transplant. Each cross represent a patient being alive at that time.Difference in OS between patients translanted in early stages and advanced stages was highly significant(p<0.001).
Figure 6. Overall survival of patients with HD and NHL after autologous to diagnosis(Lines represent: HD-- and NHL).Cumulative proportion of the patients surviving after transplant. Survival was calculated in months after CR was documented. Each cross represents a patient being alive at that time. Difference in OS between patients with HD and NHL was highly significant(p<0.001).

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