Background Bone marrow transplant (BMT) involves intravenous transference of haematopoietic stem cells (HSC) from a donor to a recipient after the administration of chemotherapy, possibly in association with radiotherapy. The HSC can be obtained from bone marrow, peripheral blood or from an umbilical cord. When they come from a compatible donor it is called allogeneic transplant (AlT); if they are obtained from the patient himself, it is called autologous transplant (AuT). The patient submits to a conditioning chemotherapy regime before the transplant takes place, generally a combination of several cytotoxics. It aims to maximise the death of tumour cells and with AlT, to suppress the recipient’s immune system reducing the risk of transplant rejection. The indication for BMT is not always clear; it depends on the disease and on the patient’s clinical condition.
Purpose To analyse the profile of candidates for bone marrow transplant. To find out which chemotherapy regimens are used for which diseases.
Materials and methods Analysis of candidates for BMT who underwent transplantation for the first time in the first half of 2013. Data collected refer to gender, age, diagnosis and conditioning chemotherapy regimen.
Results During the study period 38 patients underwent BMT for the first time, 23 were male. The average age was 54.4, the youngest being 28 years and the oldest 70. Of 38, 12 had multiple myeloma, 11 had non-Hodgkin’s lymphoma, 11 had leukaemia and 4 had other myelodysplastic syndromes. Chemotherapy regimens chosen as first line treatments were BEAM for non-Hodgkin’s lymphoma, melphalan for multiple myeloma, fludarabine plus melphalan for leukaemia, high-dose busulfan plus cyclophosphamide (BuCy) and fludarabine plus melphalan plus thiotepa for other myelodysplasias. 6 patients died during the BMT process: 3 had non-Hodgkin’s lymphoma, 2 had leukaemia and 1 had marrow aplasia.
Conclusions The most frequent pathology for this indication is multiple myeloma, followed by non-Hodgkin’s lymphoma and leukaemia being the least frequent other myelodysplasias. As usually recommended, AuT was the first-line transplant option for patients with multiple myeloma and non-Hodgkin’s lymphoma and AlT in patients with leukaemia and other myelodysplasias. The chemotherapy regimen selected is well defined and depends on the disease. The mortality rate is low (±16%) indicating the possible success of this therapeutic strategy. However, these patients will be followed up to evaluate the long-term success.
No conflict of interest.
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