Outcomes of Autologous Haematopoietic Stem Cell Transplant in Lymphomas: A Single Centre Study.

Abstract

Objective: To determine the outcomes of autologous haematopoietic stem cell transplant (auto HSCT) in lymphoma patients in terms of overall survival (OS), disease-free survival (DFS), and treatment-related mortality and to identify the associated factors.

Study design: A descriptive study. Place and Duration of the Study: Department of Clinical Haematology, The Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan, from February 2006 to 2023.

Methodology: Clinical records of 59 patients who underwent auto HSCT were analysed. Median of OS and DFS was calculated by applying Kaplan-Meier test. Log-rank test was applied to check the association of OS and DFS with multiple variables. In multivariate analysis, Cox-regression was used to check the hazard ratio of significant variables.

Results: At day 100, the transplant-related mortality of the study was 6.7%, and disease relapse was experienced in 34%. The estimated OS was 82.7% at five years and 77.6% at 14 years with median OS of 117 months. The estimated DFS was 62% at five years and 58.6% at 14 years with median DFS of 97 months. Age was the only factor significantly associated with both OS and DFS. The subtype of lymphoma, indication to transplant, and septic shock were found significantly associated with OS only. While DFS was associated with, time to relapse after first complete remission (CR). However, at multivariate analysis only septic shock and time to relapse after the first CR remained significant Conclusion: For younger, chemosensitive patients who have experienced their first CR for a longer duration, auto HSCT is a compelling therapy option in the management of lymphoma.

Key words: Transplantation, Autologous, Diffuse large cell lymphoma, Hodgkin lymphoma.