“Autologous hematopoietic stem cell transplant: a single center experience”

In this modern era, haemopoietic stem cell transplant is becoming the treatment of choice in various haematological and non-hematological diseases. Our experience of autologous HSCT in 39 patients with various indications is shared in this article.

Material and methods: This is a retrospective analysis of first nineteen patients who undergone autologous transplant at our institute, with M: F = 13: 6 and mean age 49 years (range 5-70 years). The median follow-up was 21 months with range from 1 to 84 months. The data was obtained carefully from case sheets, medical records of the hospital.

Indications for autologous HSCT were Multiple Myeloma (12 patients), Non-Hodgkin’s lymphoma (3 patients), Hodgkin lymphoma (1 patient), Seminoma (1 patient), Multiple Sclerosis (1 patient) and Neuroblastoma (1 patient).

Results: The mean time for WBC engraftment was 11 days (range: 7-18 days) and for platelet engraftment was 15 days (range: 8-34 days). Mean single-donor platelet requirement was 4 (range 1-17), and mean packed red cell requirement was 1.5 (range 0-6). The post-transplant complications encountered were mucositis, infections and diarrhoea. There were 19 incidences of febrile neutropenia, out of which in 7 (36%) infection was documented with culture positivity. Major infections were bacterial followed by fungal (5.2 %) and viral (5.2%) causes. Major bacterial infections were by Escherichia coli and Enterobacter followed by other species like Pseudomonas. One incidence of Cytomegalovirus was noted with significant viral copies that required Ganciclovir and one incidence of hepatic candidiasis was noted. Major sites of culture positivity were stool and blood. Average duration of hospital stay after autologous HSCT is 23 days with a range of 14-54 days. The mortality at our center for autologous HSCT is zero. Sixteen out of our 19 patients are in complete remission.

Conclusion: Autologous HSCT is a curable treatment option with results comparable to national and international hematopoietic stem-cell transplantation centres in terms of complications, outcomes of treatment, and cost effectiveness with an excellent safety profile.