Stem cell transplant: An experience from eastern India

Mukhopadhyay, Ashis; Gupta, P.; Basak, Jayasri; Chakraborty, Abhijit; Bhattacharyya, D.; Mukhopadhyay, Soma; Roy, Uttam Kumar

doi:10.4103/0971-5851.107078

Cited by 15 publications

(13 citation statements)

References 16 publications

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“…For example, infection rates are comparable to other Indian centres but much higher than western studies, which report bacterial infection rate of 5%, viral infection rate of 7%, and fungal infection rate of 12% [ 8 ]. The possible risk factors of infections in our patients are aggressive myeloablative conditioning regimens at our center leading to prolonged neutropenia during preengraftment period and possible environmental factors in India [ 22 ].…”

Section: Discussionmentioning

confidence: 63%

Hematopoietic Stem-Cell Transplantation in the Developing World: Experience from a Center in Western India

Shah

Karanwal

Desai

et al. 2015

Journal of Oncology

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We describe our experience of first 50 consecutive hematopoietic stem-cell transplants (HSCT) done between 2007 and 2012 at the Apollo Hospital, Gandhinagar, 35 autologous HSCT and 15 allogeneic HSCT. Indications for autologous transplant were multiple myeloma, non-Hodgkin lymphoma, Hodgkin lymphoma, and acute myeloid leukemia, and indications for allogeneic transplants were thalassemia major, aplastic anaemia, chronic myeloid leukemia, and acute lymphoblastic and myeloid leukaemia. The median age of autologous and allogeneic patient's cohort was 50 years and 21 years, respectively. Median follow-up period for all patients was 39 months. Major early complications were infections, mucositis, acute graft versus host disease, and venoocclusive disease. All of our allogeneic and autologous transplant patients survived during the first month of transplant. Transplant related mortality (TRM) was 20% (N = 3) in our allogeneic and 3% (N = 1) in autologous patients. Causes of these deaths were disease relapse, sepsis, hemorrhagic complications, and GVHD. 46% of our autologous and 47% of our allogeneic patients are in complete remission phase after a median follow-up of 39 months. 34% of our autologous patients and 13% of our allogeneic patients had disease relapse. Overall survival rate in our autologous and allogeneic patients is 65.7% and 57.1%, respectively. Our results are comparable to many national and international published reports.

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Section: Discussionmentioning

confidence: 63%

Hematopoietic Stem-Cell Transplantation in the Developing World: Experience from a Center in Western India

Shah

Karanwal

Desai

et al. 2015

Journal of Oncology

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“…Because of wide variations in the conditioning protocols and GVHD prophylaxis used, differences in supportive care practices, physician’s discretion in using the available resources and the different time periods of treatment follow-up, included in various studies, the cost factors are difficult to be compared. Still, when compared to the cost of the transplant in Europe and USA where it ranges from $30,000 to $88,000 for a single autologous transplantation to $200,000 or more for a matched unrelated myeloablative allogeneic procedure,4–7 the cost of the transplant in developing countries is much lower 2,8. In spite of this, many patients are not able to afford this due to low socio-economic condition in developing countries and lack of sufficient insurance companies and governmental support.…”

Section: Discussionmentioning

confidence: 99%

Cost of Hematopoietic Stem Cell Transplantation in India

Sharma

Choudhary

Gupta

et al. 2014

Mediterr J Hematol Infect Dis

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Hematopoietic stem cell transplantation (HSCT) is a definite cure for many hematological diseases. With the increasing indications for HSCT and its relatively low cost in Indian subcontinent, an increasing number of patients are opting for this procedure. We retrospectively analyzed the cost of one hundred sixty two HSCTs done at our center in the last three years. The median cost of autologous transplant was USD, $ 12,500 (range $ 10,331–39,367) and the median cost of allogeneic transplant was $ 17,914 (range $ 10,832–44,701). The cost of HSCT is cheaper here compared to that in developed countries and success rates are nearly equivalent. The major factors contributing to the cost are related to the complications post-transplant mainly infections and graft versus host disease, which are also the reasons for the increased stay in the hospital.

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“…The same trend was seen also in Norway and the Netherlands [7]. To break the trend, different changes in the systems have been made [8-12] and major resources been transferred from the social insurance system to the health care system, as incentives to improve rehabilitation and sick leave management. From 2009, approximately one hundred million Euros have been available on a yearly basis for the regional health authorities to improve the sick-listing process [13].…”

Section: Introductionmentioning

confidence: 86%

Promoting work ability in a structured national rehabilitation program in patients with musculoskeletal disorders: outcomes and predictors in a prospective cohort study

Stigmar

Petersson

Jöud

et al. 2013

BMC Musculoskelet Disord

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BackgroundMusculoskeletal disorders (MSDs) are a major reason for impaired work productivity and sick leave. In 2009, a national rehabilitation program was introduced in Sweden to promote work ability, and patients with MSDs were offered multimodal rehabilitation. The aim of this study was to analyse the effect of this program on health related quality of life, function, sick leave and work ability.MethodsWe conducted a prospective, observational cohort study including 406 patients with MSDs attending multimodal rehabilitation. Changes over time and differences between groups were analysed concerning function, health related quality of life, work ability and sick leave. Regression analyses were used to study the outcome variables health related quality of life (measured with EQ-5D), and sick leave.ResultsFunctional ability and health related quality of life improved after rehabilitation. Patients with no sick leave/disability pension the year before rehabilitation, improved health related quality of life more than patients with sick leave/disability pension the year before rehabilitation (p = 0.044). During a period of −/+ four months from rehabilitation start, patients with EQ-5D ≥ 0.5 at rehabilitation start, reduced their net sick leave days with 0.5 days and patients with EQ-5D <0.5 at rehabilitation start, increased net sick leave days with 1.5 days (p = 0.019). Factors negatively associated with sick leave at follow-up were earlier episodes of sick leave/disability pension, problems with exercise tolerance functions and mobility after rehabilitation. Higher age was associated with not being on sick leave at follow-up and reaching an EQ-5D ≥ 0.5 at follow-up. Severe pain after rehabilitation, problems with exercise tolerance functions, born outside of Sweden and full-time sick leave/disability pension the year before rehabilitation were all associated with an EQ-5D level < 0.5 at follow-up.ConclusionsPatients with MSDs participating in a national work promoting rehabilitation program significantly improved their health related quality of life and functional ability, especially those with no sick leave. This shows that vocational rehabilitation programs in a primary health care setting are effective. The findings of this study can also be valuable for more appropriate patient selection for rehabilitation programs for MSDs.

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Stem cell transplant: An experience from eastern India

Cited by 15 publications

References 16 publications

Hematopoietic Stem-Cell Transplantation in the Developing World: Experience from a Center in Western India

Hematopoietic Stem-Cell Transplantation in the Developing World: Experience from a Center in Western India

Cost of Hematopoietic Stem Cell Transplantation in India

Promoting work ability in a structured national rehabilitation program in patients with musculoskeletal disorders: outcomes and predictors in a prospective cohort study

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