Longitudinal outcome over four decades of allogeneic stem cell transplantation: a single center experience.

Autores de IIS La Fe

• Miguel Ángel Sanz Alonso

  Autor

• Juan Bautista Montoro Gómez

  Autor

• Aitana Balaguer Roselló

  Autor

• Pedro Miguel Aparicio Chorao

  Autor

• Marta Villalba Montaner

  Autor

• Inés Gómez Seguí

  Autor

• Pilar Solves Alcaina

  Autor

• Marta Santiago Balsera

  Autor

• Pedro Asensi Cantó

  Autor

• Ana María Bataller Alfonso

  Autor

• Alberto Louro Iglesias

  Autor

• 

  Javier De La Rubia Comos

  Autor

• Jaime Sanz Caballer

  Autor

Participantes ajenos a IIS La Fe

• Lamas, Brais
• Granados, Pablo
• Eiris, Juan
• Martinez, David
• Lloret, Pilar
• Rebollar, Paula
• Perla, Aurora

Grupos

• Hematología y Hemoterapia

Abstract

This 45-year study (1978-2022) at a single institution evaluated HSCT outcomes and complications, emphasizing recent advances, with to provide insights into HSCT's evolving field and ongoing efforts to enhance patient outcomes. Involving 1707 patients, the study revealed an initial phase (1978-1987) with a limited activity that yielded modest outcomes, a nearly three-decade span (1988-2016) with a substantial increase in transplant activity, emphasizing umbilical cord blood transplantation (UCBT) for patients lacking a suitable matched sibling donor. In addition to a gradual increase in recipient age, significant improvement in outcomes emerged in the recent period (2017-2022), marked by UCBT replacement with haploidentical transplants, introduction of PTCY-based GVHD prophylaxis for all type of transplants, and increased use of conditioning regimens with thiotepa, busulfan, and fludarabine. In this period, reductions in GVHD, non-relapse mortality, and relapse rates significantly contributed to improved overall survival, event-free survival, and GVHD-free/relapse-free survival. The study identified specific factors, including GVHD prophylaxis and donor selection changes, associated with these positive trends. This four-decade study provides a unique perspective on allogeneic HSCT, showcasing the dynamic evolution of transplantation practices and their impact on outcomes, offering valuable insights for personalized treatment approaches and emphasizing continual innovation in this critical therapeutic modality.

© 2024. The Author(s), under exclusive licence to Springer Nature Limited.

Keywords

• VERSUS-HOST-DISEASE; UMBILICAL-CORD BLOOD; BONE-MARROW-TRANSPLANTATION; ACUTE MYELOID-LEUKEMIA; POSTTRANSPLANTATION CYCLOPHOSPHAMIDE; HEMATOLOGIC MALIGNANCIES; CHRONIC GRAFT; HIGH-RISK; DONOR; SIROLIMUS