Hematopoietic stem cell transplantation in Lebanon: first comprehensive report

Area of Science:

• Hematology
• Oncology
• Transplantation Medicine

Background:

• Hematopoietic stem cell transplantation (HSCT) is a crucial curative therapy for various hematologic malignancies and nonmalignant disorders.
• Lebanon's major Bone Marrow Transplant (BMT) units have accumulated a decade of HSCT experience.

Purpose of the Study:

• To comprehensively report the outcomes of HSCT performed over the first 10 years at two leading Lebanese BMT centers.
• To evaluate the feasibility and survival rates of allogeneic and autologous HSCT in the Lebanese population.

Main Methods:

• Retrospective analysis of 84 allogeneic HSCT and 228 autologous BMT cases.
• Detailed reporting of overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and transfusion-free survival (TFS) stratified by disease and transplant type.
• Analysis of treatment-related mortality (TRM) and acute graft-versus-host disease (GVHD) for allogeneic transplants.

Main Results:

• Median OS was 97 months (5-year OS 58%) for allogeneic HSCT and 60 months (5-year OS 50%) for autologous BMT.
• For myeloablative allogeneic HSCT: AML (5-year OS 58%), CML (5-year OS 66%), ALL (2-year OS 10%), Thalassemia (5-year TFS 67%).
• For autologous HSCT: DLBCL (5-year OS 68%), Hodgkin's lymphoma (5-year OS 55%), Multiple Myeloma (5-year OS 53%). Cumulative TRM was 23% for allogeneic and 2.6% for autologous transplants.

Conclusions:

• Allogeneic and autologous HSCT are feasible in Lebanon, yielding outcomes comparable to international standards.
• Despite socioeconomic challenges, Lebanese BMT centers achieve successful HSCT results for diverse hematologic conditions.
• The data supports the continued development and accessibility of HSCT services in the region.