الفهرس 
INDICATIONS OF HEMOPOIETIC STEM CELLS TRANSPLANTATIONOnly 14 pages are availabe for public view
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Abstract
Hematopoietic stem cell transplantation (HSCT) has
become the standard of care for many patients with
defined congenital or acquired disorders of the hematopoietic
system or with chemosensitive, radiosensitive, or immunosensitive
malignancies.
Non-Hodgkin lymphoma (NHL) is a heterogeneous
group of hematologic malignancies, known to be associated
with chronic inflammatory diseases such as Sjögren syndrome,
celiac disease, and rheumatoid arthritis.
Autologous stem cell transplantation (SCT) has
frequently been used in these patients because these
lymphomas are generally very sensitive to chemotherapy and
radiation therapy.
The percentage of allogeneic HSCT for lymphoma has
markedly increased over recent years due to the introduction of
reduced-intensity conditioning allogeneic HSCT.
The postulated advantages of an allo- HSCT include the
use of a tumor-free graft and immune-mediated graft-versuslymphoma effects, but the survival benefit is usually offset by a
nonrelapse mortality rate. As seen with other transplant
indications, any reduction in relapse achieved with alloHSCTis offset by mortality attributable to the treatment itself. The development of less intensive but highly
immunosuppressive conditioning regimens that rely on possible
graft-versus-tumor effects have increased the number of
patients who are candidates for allografts, including those who
relapse after auto-HSCT.
The study is aimed to assess the clinical outcome in
Egyptian patients diagnosed with lymphomas subjected to
hemopoietic allogeneic stem cell transplantation from Human
Leukocyte Antigen identical sibling donors
This is A Retrospective study, carried out on 35 patients
with Lymphoma, at Bone Marrow Transplantation Unit at
Nasser Institute Hospital, from May 1997 to August 2018.
The main results of the study revealed that:
Among the studied cases (n=39) there were 33 (84.6%)
males and 6 (15.4%) females and there were 21 (53.8%)
with age less than 30 and 18 (46.2%) with age more than 30;
the mean age was 28.09 ± 12.07 with range (6-53).
Among the studied cases there were 9 (23.1%) with H.D, 13
(33.3%) with NHL, 5 (12.8%) with Burkett’s lymphoma, 10
(25.6%) with Lymphoblastic Lymphoma, 1 (2.6%) with
H.D and 1 (2.6%) females.
Among the studied cases there were 10 (25.6%) P and 29
(74.4%) A Among the studied cases the mean TLC 500 was 11.46 ±
3.95 with range (0-21), the mean TLC 1000 was 13.0 ± 4.43
with range (0-22), the mean Plat. 25000 was 11.92 ± 4.81
with range (0-26), the mean Plat. 100000 was 11.82 ± 8.01
with range (0-33) and the mean Abs. was 16.18 ± 12.30 with
range (0-61).
According to Acute/0-1 there were 35 (89.7%) not acute, 3
(7.7%) GIT and 1 (2.6%) GIT/Skin, according to
AGVHD/2-4 there were 31 (79.5%) No and 8 (20.5%) Yes,
according to chronic/ (Denovo, ST) there were 37 (94.9%)
No and 2 (5.1%) Yes, according to CGVHD/ 2ry (progr)
there were 37 (94.9%) No and 2 (5.1%) Mild, liver and
according to chronic GVHD-Lim/Ext there were 32
(82.1%) No and 7 (17.9%) Yes.
Among the studied cases the mean Hospital Stay was 41.31
± 16.55 with range (21-105) and the mean CD34 Cells was
7.06±3.0 with range (2.9-16).
Among the studied cases the mean RBCs was 2.41 ± 4.60
with range (0-28) and the mean Plat. was 2.69 ± 4.43 with
range (0-26).
Among the studied cases there were 11 (28.2%) Bu/Cy, 10
(25.6%) TBI/CY, 13 (33.3%) FLU/ALK and 5 (12.8%)
FLU/BU/post Cy.Among the studied cases there were 39 (100%) with CSA,
21 (53.8%) with MTX, 14 (35.9%) with MMF and 2 (5.1%)
with STD.
According to CMV there were 25 (64.1%) NO and 14
(35.9%) yes, according to D.O relapse there were 34
(87.2%) No and 5 (12.8%) Yes, according to Mortality there
were 14 (35.9%) Died and 25 (64.1%) alive.
Among the studied cases there were 5 (12.8%) with HCV
Ab, 5 (12.8%) with HCV PCR, 2 (5.1%) with HBsAg, 9
(23.1%) with HBsAB, 2 (5.1%) with HBcAb, 1 (2.6%) with
HIV, 33 (84.6%) with CMV IgG, 1 (2.6%) with CMV IgM,
7 (17.9%) with Tox. IgG and 0 (0%) with Tox. IgM.
According to Kaplan-Meier survival curve the mean overall
survival was 20.497 and the median was 78.400 with 0%
percent.
There was no significant difference between the
AGVHD/2–4 yes and no groups as regard Sex, Age,
Diagnosis, A.P, TLC 500, TLC 1000, Plat. 25000 or Plat.
100000.
There was significant difference between the AGVHD/2–4
yes and no groups as regard Hospital Stay and RBCs.
There was no significant difference between the
AGVHD/2–4 yes and no groups as regard Abs., Acute/0-1, chronic/ (Denovo, ST), CGVHD/ 2ry (progr), chronic
GVHD-Lim/Ext, CD34 Cells or Plat.
There was significant difference between the AGVHD/2–4
yes and no groups as regard MMF, STD, CMV, Mortality,
HCV Ab and HCV PCR.
There was no significant difference between the
AGVHD/2–4 yes and no groups as regard Cond., MTX,
D.O relapse, HBsAg, HBsAB, HBcAb, HIV, CMV IgG,
CMV IgM, Tox. IgG or Plat.
Based on our results we recommend for further studies n
larger patients and longer period of follow up to emphasize our
conclusion.