Long term outcomes of hematopoietic stem cell transplantation in Thailand- a 20-year, single center, retrospective cohort study

Abstract

Background: Data regarding Hematopoietic Stem Cell Transplantation (HSCT) in a developing country are limited. This study aimed to analyze the long term HSCT outcomes at the 20th anniversary of our program. Methods: Data were gathered retrospectively among patients who received transplants between January 2000 and December 2020. The statistical method used for analyzing the categorical data involved the Chi square method, and the independent T-test was used for continuous data. OS and RFS were analyzed using the Kaplan-Meier method and the test of differences between types of HSCT and between disease indications for HSCT were assessed using the log rank test. Results: A total of 201 transplantations were performed, and 186 patients were eligible for the survival analysis. The five-year overall survival (OS) and relapse-free survival (RFS) for the whole cohort were 62.3 and 55%, respectively. The ten-year OS and RFS were 50.5 and 53.2% respectively. For auto-, allo-, and haplo-HSCT, five-year OS were 63.9, 60.3 and 50%; while ten-year OS were 52.8, 47.7 and 50%, respectively (p = 0.411). Five-year RFS were 38, 71.3 and 50.5%; and ten-year RFS were 30.4, 71.3 and 50.5%, respectively (p = 0.002). Transplant-related mortality rates were 4.6, 12.9 and 21.4%, respectively. Nonrelapse mortality occurred among 36 patients (20.3%). For allo- and haplo-SCT, the incidence of acute graft-versus-host disease (GVHD) were 30.7 and 12.5% respectively, and chronic GVHD incidences were 32 and 37.5%, respectively. Conclusion: This study provided long term transplant outcome and showed impressive outcome both for autologous and allogeneic SCT despite a limited setting. This encouraged performing the procedure in developing countries.