Contributions
Abstract: PB2464
Type: Publication Only
Background
Several factors affect the outcome of allogeneic stem cell transplantation (Allo-SCT) in hematologic malignancies patients. Proximity to the transplant center could be an independent factor that affects overall survival (OS). This study has been conducted at American University of Beirut Medical Center (AUBMC), a referral center for the Middle East located in Lebanon.
Aims
Our aim was to determine the differences in the survival between patients residing in Lebanon and those referred from abroad.
Methods
We identified 161 consecutive adults patients who underwent allo-SCT between January 2007 and December 2016. One hundred and three patients (64%) were residing in Lebanon, and 58 patients (36%) were referred from abroad. Follow up on patients residing in Lebanon was done mainly via regular clinic visits, while those residing outside Lebanon was either by clinic appointment, and/or phone calls in case they could not travel to Lebanon. All patients and transplant characteristics are listed in table 1.
Results
All patients engrafted. The median time to neutrophil engraftment was 15 days in both
groups but with different ranges (10-23) and (9-35) days in local and foreign groups respectively.
In Local group 68 (66%) patients were in Complete remission (CR) at transplant, from those 39 (57) were in first CR (CR1), 18 (26) were in second CR (CR2), and 11(16) were third CR (CR3). vs. 35 (34%) were in progression disease/relapsed disease (PR/RD) and Stable disease/partial response(SD/PR) at transplant, in foreign group 34 (59%) patients were at CR at time of transplant, from those 20 (59) were in CR1, 8(23) were in CR2, and 6(18) were in CR3, while 24 (41%) patients were in PR/RD and (SD/PR) at time of transplant. The incidence of acute graft versus host disease (aGVHD) was higher in local group with 30 cases (29%) and 11 cases (19%) in foreign group (P= 0.188). Similarly, the incidence of chronic graft versus host disease (cGVHD) in local group was superior to foreign group, with 23 (22%) patients vs. 11 (19%) patients respectively (P =0.6904). After a median follow up of 16 months (range, 1-99), 59 (57%) and 34 (59%) patients were alive in the local and foreign group respectively. The median OS was 55 months in local groups, but it has not been reached in foreign group. The median progression free survival (PFS) has not been reached in both groups. The cause of death was classified into two categories, disease related and TRM. In the local group, 44 (43%) patients died, from those, 27 (26%) were disease related and 17 (14%) due to TRM. Whereas 24 (41%) patients died in foreign group, from those 12 (21%) deaths were disease related, while 7 (12%) deaths were TRM.
Conclusion
Our results imply that the geographical distance has no impact on the OS, however, we have found that it might have impact on the PFS, but we should take into consideration that more patients in local group underwent Haploidentical bone marrow transplant. These findings need to be verified in larger scale studies.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Progression, Survival, Transplant, Transplant-related mortality
Abstract: PB2464
Type: Publication Only
Background
Several factors affect the outcome of allogeneic stem cell transplantation (Allo-SCT) in hematologic malignancies patients. Proximity to the transplant center could be an independent factor that affects overall survival (OS). This study has been conducted at American University of Beirut Medical Center (AUBMC), a referral center for the Middle East located in Lebanon.
Aims
Our aim was to determine the differences in the survival between patients residing in Lebanon and those referred from abroad.
Methods
We identified 161 consecutive adults patients who underwent allo-SCT between January 2007 and December 2016. One hundred and three patients (64%) were residing in Lebanon, and 58 patients (36%) were referred from abroad. Follow up on patients residing in Lebanon was done mainly via regular clinic visits, while those residing outside Lebanon was either by clinic appointment, and/or phone calls in case they could not travel to Lebanon. All patients and transplant characteristics are listed in table 1.
Results
All patients engrafted. The median time to neutrophil engraftment was 15 days in both
groups but with different ranges (10-23) and (9-35) days in local and foreign groups respectively.
In Local group 68 (66%) patients were in Complete remission (CR) at transplant, from those 39 (57) were in first CR (CR1), 18 (26) were in second CR (CR2), and 11(16) were third CR (CR3). vs. 35 (34%) were in progression disease/relapsed disease (PR/RD) and Stable disease/partial response(SD/PR) at transplant, in foreign group 34 (59%) patients were at CR at time of transplant, from those 20 (59) were in CR1, 8(23) were in CR2, and 6(18) were in CR3, while 24 (41%) patients were in PR/RD and (SD/PR) at time of transplant. The incidence of acute graft versus host disease (aGVHD) was higher in local group with 30 cases (29%) and 11 cases (19%) in foreign group (P= 0.188). Similarly, the incidence of chronic graft versus host disease (cGVHD) in local group was superior to foreign group, with 23 (22%) patients vs. 11 (19%) patients respectively (P =0.6904). After a median follow up of 16 months (range, 1-99), 59 (57%) and 34 (59%) patients were alive in the local and foreign group respectively. The median OS was 55 months in local groups, but it has not been reached in foreign group. The median progression free survival (PFS) has not been reached in both groups. The cause of death was classified into two categories, disease related and TRM. In the local group, 44 (43%) patients died, from those, 27 (26%) were disease related and 17 (14%) due to TRM. Whereas 24 (41%) patients died in foreign group, from those 12 (21%) deaths were disease related, while 7 (12%) deaths were TRM.
Conclusion
Our results imply that the geographical distance has no impact on the OS, however, we have found that it might have impact on the PFS, but we should take into consideration that more patients in local group underwent Haploidentical bone marrow transplant. These findings need to be verified in larger scale studies.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Progression, Survival, Transplant, Transplant-related mortality