Contributions
Abstract: PB2473
Type: Publication Only
Background
A comprehensive analysis of the results of haploidentical hematopoietic stem cell transplantation in adult patients have been performed for the first time during the period from October 2011 to July 2017. The incidence of acute and chronic graft versus host disease, overall survival and mortality were assessed.
Aims
To assess the total and relapse-free survival in patients after haploidentical transplantation of hematopoietic stem cells.
Methods
Considering the absence of generally recognized protocol on the date of beginning of haploidentical transplantation of hematopoietic stem cells to be used in the Republic of Kazakhstan, different conditioning and prevention regimens for acute and chronic graft versus host disease were used.
Results
At this time, 23 of 64 patients are alive amounting to 36%. The follow-up period is within 4 to 7 days. The median overall survival of the patients followed up is 2.58 months. The curve of overall survival contains tow plateaus. The 1st plateau is patients with relatively short follow-up period equal to 12-20 months. However, the median overall survival was reached in these patients. The 2nd plateau is the group of patients with follow-up period within 22 to 47 months. The cumulative survival percentage is 27%. The median overall survival of the patients followed up is 4.1 months. The cumulative survival percentage is 39%. Despite insignificant differences in the overall survival between the two groups of patients, the percentage and overall survival length are higher in the group of patients with their haploSCT in the 1st complete remission. The follow-up period is not long enough to analyze 5-years overall and relapse-free survival. At present, however, we note the significant difference in the median OS – 2.58 in the general group vs 4.1 months in the group of patients with acute leukemias in the 1st remission.
Conclusion
The obtained results are comparable to those that presented in foreign studies. The frequency of acute GVHD of Grades II-IV was 26.6%, i.e. practically comparable to this parameters of 21.9% presented in the study performed by Long H. et al [4]. In relation to chronic GVHD, the parameter observed in our Department is significantly lower than the frequency reported in the above study – 11% vs 24.1%. However, at this stage of follow-up we could not conclude that development of chronic GVHD in haploSCT recipients in our Department is significantly more rare. This is explained by the fact that the follow-up period is still insufficient to a valid analysis of this parameter, a part of patients is followed up for less than 100 days. Also, a rather high mortality in the early posttransplantation period was observed. The equivalent comparison of the frequency of chronic GVHD requires a longer follow-up period. The parameter of OS in the general group of patients is lower than this parameter in foreign studies – 29% vs 52.6%. This is provided by unfavorable disease status on the date of transplantation and development of severe complications in the early posttransplantation period. However, the analysis of more homogeneous group of recipients with acute leukemias in the 1st complete remission shows a higher OS – 39%.Based on the results of our clinical analysis, the following may be concluded:Considering certain difficulties with organization of nonsibling transplantation of bone marrow in the Republic of Kazakhstan, one of the main tasks at this stage of development of hematological practice in the Republic is developing the haploidentical bone marrow transplantation
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Graft-versus-host disease (GVHD), Haploidentical stem cell transplantation, Overexpression
Abstract: PB2473
Type: Publication Only
Background
A comprehensive analysis of the results of haploidentical hematopoietic stem cell transplantation in adult patients have been performed for the first time during the period from October 2011 to July 2017. The incidence of acute and chronic graft versus host disease, overall survival and mortality were assessed.
Aims
To assess the total and relapse-free survival in patients after haploidentical transplantation of hematopoietic stem cells.
Methods
Considering the absence of generally recognized protocol on the date of beginning of haploidentical transplantation of hematopoietic stem cells to be used in the Republic of Kazakhstan, different conditioning and prevention regimens for acute and chronic graft versus host disease were used.
Results
At this time, 23 of 64 patients are alive amounting to 36%. The follow-up period is within 4 to 7 days. The median overall survival of the patients followed up is 2.58 months. The curve of overall survival contains tow plateaus. The 1st plateau is patients with relatively short follow-up period equal to 12-20 months. However, the median overall survival was reached in these patients. The 2nd plateau is the group of patients with follow-up period within 22 to 47 months. The cumulative survival percentage is 27%. The median overall survival of the patients followed up is 4.1 months. The cumulative survival percentage is 39%. Despite insignificant differences in the overall survival between the two groups of patients, the percentage and overall survival length are higher in the group of patients with their haploSCT in the 1st complete remission. The follow-up period is not long enough to analyze 5-years overall and relapse-free survival. At present, however, we note the significant difference in the median OS – 2.58 in the general group vs 4.1 months in the group of patients with acute leukemias in the 1st remission.
Conclusion
The obtained results are comparable to those that presented in foreign studies. The frequency of acute GVHD of Grades II-IV was 26.6%, i.e. practically comparable to this parameters of 21.9% presented in the study performed by Long H. et al [4]. In relation to chronic GVHD, the parameter observed in our Department is significantly lower than the frequency reported in the above study – 11% vs 24.1%. However, at this stage of follow-up we could not conclude that development of chronic GVHD in haploSCT recipients in our Department is significantly more rare. This is explained by the fact that the follow-up period is still insufficient to a valid analysis of this parameter, a part of patients is followed up for less than 100 days. Also, a rather high mortality in the early posttransplantation period was observed. The equivalent comparison of the frequency of chronic GVHD requires a longer follow-up period. The parameter of OS in the general group of patients is lower than this parameter in foreign studies – 29% vs 52.6%. This is provided by unfavorable disease status on the date of transplantation and development of severe complications in the early posttransplantation period. However, the analysis of more homogeneous group of recipients with acute leukemias in the 1st complete remission shows a higher OS – 39%.Based on the results of our clinical analysis, the following may be concluded:Considering certain difficulties with organization of nonsibling transplantation of bone marrow in the Republic of Kazakhstan, one of the main tasks at this stage of development of hematological practice in the Republic is developing the haploidentical bone marrow transplantation
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Graft-versus-host disease (GVHD), Haploidentical stem cell transplantation, Overexpression