Small Centers with Big Ventures: Autologous Stem Cell Transplantation Survival Data

Muhammad Bilal Abid,Mustafa Mughal,Ranjeet Babbra,Norbert Blesing,Muhammad Abbas Abid,Saiyed Anwer

doi:10.31557/apjcp.2019.20.4.987

Abstract

We present the first-ever autologous stem cell transplantation (ASCT) outcome data from a secondary-care healthcare facility. Albeit exact details of patient and disease characteristics and co-morbidity scores for all patients are not available, the engraftment and survival data is very similar to those published from large tertiary-care cancer centres, both regionally and internationally. Transplant Related Mortality (TRM) of 3.1% is within the expected range and includes a patient who died of acute drug reaction (ADR) during conditioning chemotherapy, prior to the ASCT. Furthermore, cyclophosphamide mobilization chemotherapy is given in the outpatient setting. This study is important in terms of healthcare resource optimization as well as patients’ convenience and highlights that ASCT can be performed in a safe and effective manner with comparable survival rates even at a DGH, provided the centre stays abreast with the recent developments and can offer its patients with standard of care treatment of the era.

Highlights

Autologous stem cell transplantation (ASCT) remains the leading method of bone marrow transplantation (BMT), both in the upfront and in the salvage settings, either with a curative-intent or as a survival-prolonging strategy for multiple myeloma (MM) and lymphoma
Transplant Related Mortality (TRM) of 3.1% is within the expected range and includes a patient who died of acute drug reaction (ADR) during conditioning chemotherapy, prior to the autologous stem cell transplantation (ASCT)
Great Western Hospital (GWH) has kept abreast with developments and has rendered its patients with the standard-of-care treatment, either through National Health Service (NHS), industry or via compassionate drug fund (CDF)

Summary

Introduction

Autologous stem cell transplantation (ASCT) remains the leading method of bone marrow transplantation (BMT), both in the upfront and in the salvage settings, either with a curative-intent or as a survival-prolonging strategy for multiple myeloma (MM) and lymphoma. Child et al, (2003) demonstrated that high-dose therapy (HDT) followed by ASCT prolongs survival in transplant-eligible MM patients, whereas this strategy holds potential for cure for a fraction of patients with relapsed/refractory Hodgkin’s (HL) and Non-Hodgkin’s Lymphoma (NHL) (Gerrie et al, 2014; Philip et al, 1995). Great Western Hospital (GWH) in the southwest city of Swindon, England is one such secondary-level centre which is JACIE-accredited and perform ASCT regularly

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