Short- and long-term outcomes of allogenic haematopietic stem cell transplant performed in non-HEPA 64257; ltered single rooms: a single- centre experience from India

Ref ID: 18574

Author:

M. Mahapatra, P. Mishra, T. Seth, N. Rathod, S. Rathi,
R. Saxena

Author address:

AIIMS (New Delhi, IN)

Full conference title:

Annual Meeting of the EBMT, 36th

Abstract:

Background: In India, there is an urgent need to enhance the
hematopoietic stem cell transplant (HSCT) facilities. It is also
important to be certain that these procedures can be carried out
within the existing infrastructure of hospitals with requisite expertise. There is a lack dedicated HSCT units equipped with special
air-handling facilities and high-effi ciency particulate air (HEPA)
fi lter rooms. It is important to ascertain the safety of performing
allogenic HSCT in single rooms without HEPA fi lters.
Aim of study: To evaluate the short and long term outcomes of
allogenic HSCT performed in non-HEPA fi ltered single rooms.
Patients and methods: We analyzed sixty-six consecutive
patients, who underwent an allogenic HSCT performed in nonHEPA fi ltered air-conditioned single rooms with barrier nursing, over a period of 4 years from July 2005 to August 2009.
The preferred source of stem cells G-CSF mobilized peripheral blood stem cells (PBSC). In small donors, where PBSC
was technically diffi cult, bone marrow was harvested under
anesthesia. All patients received antibacterial and antifungal
and antiviral prophylaxis. At the onset of fever, systemic antibiotics were started. Antifungal agents were added if fever persisted for 3 days.
Results: We present our experience of performing sixty six allogenic transplant. Source of stem cell was peripheral blood in
56, bone marrow in 9 and combined in 1. The indications were
severe aplastic anemia (SAA)-30, CML-10, AML-8, ALL-5,
Biphenotypic AL-1, Thalassemia-9, and Myelodysplastic syndrome -3. The median age was 24 years (range 2.2-46) with
16 females and 50 males. Median time for neutrophil engraftment was 10 days (range 8-17). Fever occurred in 59 (89%)
for a median of 5 days (range 1-38), Systemic antibiotics were
used in 88% and antifungal in 52% cases. The 30-day mortality
was 3 (4.7%), and 100-day mortality was 5 (7.8%). After day
100, there were seventeen fatalities (26.5%) due to chronic
GVHD-5, relapse-2, graft rejection-2, infections like disseminated tuberculosis-1 and aspergillosis-3, Veno-occlusive disease (VOD)-2 and platelet refractoriness leading to intracranial
bleed-2.
Conclusion: Our experience suggests that availability of dedicated BMT unit with special air handling equipment should not
be considered a critical and essential precondition for providing
allogeneic HSCT who would otherwise succumb to potentially
curable hematological diseases.

Abstract Number: P665

Conference Year: 2010

Link to conference website: NULL

New link: NULL

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