AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION IN ITS MAIN INDICATIONS: A SINGLE-CENTER, RETROSPECTIVE STUDY OF 30 YEARS

30 years of HSCT

Resumo

Objective: Autologous hematopoietic stem cell transplantation is widely used in patients with hematological cancers and in some solid tumors. We aimed to describe the transplant procedures performed in a single institution along 30 years.

Methods: We describe retrospectively the autologous transplants performed from 1987 to 2016 for: acute myeloid leukemia (AML), Hodgkin (HL) and non-Hodgkin lymphoma (NHL), and multiple myeloma (MM).

Results: We analyzed 378 consecutive patients, all with neutrophil engraftment, which was faster with higher CD34 counts (p=0.0001) and slower in patients with AML (p=0.003). Five-year overall survival (OS) was 61%. Receiving transplant in the most recent period (2008-2017) was a protective factor (p<0.0001). For MM, the incidence of relapse was significantly higher in patients not achieving a partial response (hazard ratio, HR = 4.02, p = 0.03). For lymphomas, both patients with partial response (p=0.003) and refractory (p=0.007) had higher relapse rates. The 5-year incidence of disease relapse was 42% for AML, 49% for MM, 41% for HL and 41% for NHL (p=0.88). Non-relapse mortality was 13% in 1 year.

Conclusion: There was an improvement in the outcomes of patients undergoing autologous transplants for oncological and onco-hematological diseases across the last 30 years in our institution.