Bone marrow transplantation in Taiwan: an overview

Area of Science:

• Hematology
• Transplantation Medicine
• Hepatology

Background:

• Bone marrow transplantation (BMT) is a critical treatment for various hematologic and oncologic conditions.
• Taiwan has a high prevalence of Hepatitis B Virus (HBV) infection, posing unique challenges in transplantation.
• Thalassemia represents a significant indication for allogeneic BMT in Taiwan.

Purpose of the Study:

• To review bone marrow transplant (BMT) activities and outcomes in Taiwan from 1983 to 1993.
• To assess the impact of Hepatitis B Virus (HBV) on BMT outcomes in a high-prevalence population.
• To evaluate BMT for thalassemia and identify causes of treatment failure.

Main Methods:

• Retrospective analysis of 388 BMTs (308 allogeneic, 80 autologous) performed between November 1983 and October 1993.
• Review of common indications, complications, and survival rates.
• Analysis of outcomes in patients with Hepatitis B Virus (HBV) infection, considering donor and recipient carrier status.

Main Results:

• Overall BMT results in Taiwan are comparable to international data.
• Thalassemia accounted for 10% of allogeneic BMTs, with a 44% disease-free survival, primarily limited by graft rejection.
• Abnormal liver function was the most common complication, potentially HBV-related; 2% of HBV carrier cases experienced fatal hepatic failure.

Conclusions:

• BMT in Taiwan is effective but faces challenges, particularly graft rejection in thalassemia patients.
• The high prevalence of HBV in Taiwan necessitates careful management and further study of its role in BMT complications and prognosis.
• The development of an unrelated marrow donor registry and peripheral stem cell programs are emerging initiatives.