Retrospective study of adult autologous hematopoietic stem cell transplantation cases in the bone marrow transplant units of Tanta and Alexandria University hospitals: a two-center experience

Context Autologous hematopoietic stem cell transplantation (AHSCT) is the standard therapy for relapsed Hodgkin lymphoma and diffuse large B-cell lymphoma, and is also used as upfront consolidation in mantle cell lymphoma and selected T-cell lymphomas. AHSCT is indicated for all eligible myeloma patients, who respond to first-line therapy and may be considered for autoimmune diseases unresponsive to conventional treatment. Aims To review the experience of two centers with adult AHSCT, focusing on potential hazards, mortality, and possible complications to minimize financial obstacles and enhance comprehensive integration. Settings and design Retrospective study. Patients and methods A total of 103 consecutive adult patients underwent AHSCT at the bone marrow transplantation units of Tanta and Alexandria University Hospitals between October 2018 and October 2022. Statistical analysis SPSS, version 25 (IBM Corp., Armonk, New York, USA). Results Early nonrelapse mortality by day +100 was 3.9%, while the 1-year nonrelapse mortality reached 5.8%. Sepsis was the leading cause of early posttransplant mortality. The 1-year disease-free survival rate was 69% (78% in plasma cell disorders and 60% in lymphoma patients). The 1-year overall survival was ~65% (93% in plasma cell disorders compared with 82% in lymphomas). Neutropenic fever and mucositis were the most frequent conditioning-related toxicities. Conclusion Infections and regimen-related toxicities were the primary contributors to transplant-related mortality. Optimizing infection control and supportive care measures is essential for achieving outcomes comparable to international standards.