Allogeneic hematopoietic stem cell transplantation in Tunisia

Area of Science:

• Hematology
• Transplantation Medicine
• Oncology

Background:

• The Centre National de Greffe de Moelle Osseuse introduced allogeneic hematopoietic stem cell transplantation (AHSCT) in Tunisia in 1998.
• Data from 299 initial AHSCT procedures and 12 retransplants were analyzed up to June 2007.

Purpose of the Study:

• To evaluate the outcomes and safety of allogeneic hematopoietic stem cell transplantation (AHSCT) in Tunisia.
• To assess the efficacy of AHSCT for various hematological conditions, including aplastic anemia, leukemia, and Fanconi anemia.

Main Methods:

• Retrospective analysis of 299 patients undergoing first AHSCT and 12 retransplants.
• Data collection included patient demographics, indications for transplantation, preparative regimens, stem cell sources (bone marrow and peripheral blood stem cells), and patient outcomes.
• Follow-up data were analyzed to determine survival rates and treatment-related mortality (TRM).

Main Results:

• The median patient age was 19 years, with aplastic anemia (36%) and leukemia/nonmalignant disorders (51%) as primary indications.
• Bone marrow (87%) was the predominant stem cell source, with HLA geno-identical donors used in all cases.
• A survival rate of 67% was observed at a median follow-up of 42 months, with an overall TRM rate of 17%.

Conclusions:

• Allogeneic HSCT is a potentially curative option for hematological diseases in Tunisia.
• The procedure demonstrates significant toxicity, especially when applied to malignant disorders, necessitating careful consideration of risk-benefit ratios.