Twenty Years of Experience on Stem Cell Transplantation in Iran

Abstract

BackgroundHematopoietic stem cell transplantation (HSCT) is a new window to therapy of many diseases. From March 1991 through April 2011, a total of 3237 HSCT were performed in the Hematology-Oncology and Stem Cell Transplantation Research Center, affiliated to Tehran University of Medical Sciences. Here we report 20 years experience of HSCT.ObjectivesOur strategy and aim include the protraction of cytogenetic and molecular biological diagnostic tests, the expansion of the first Iranian Cord Blood Bank (ICBB) and development of the first Iranian Stem Cell Donor Program (ISCDP), and improvement the researches in new therapeutic fields.Patients and MethodsTotally, 3237 patients were undergone HSCT. Of these transplants, 2205 were allogeneic stem cell transplantation, 1016 autologous and 16 syngeneic. Among 2205 patients who were undergone allogenic-HSCT, 34 received cord blood stem cells as stem cell source for transplantation. It is important to point out that cord blood bank at our center provides reliable storage of cord blood stem cells for our patients. Stem cell transplantation was performed for treatment of various diseases such as acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, chronic lymphoblastic leukemia, beta-thalassemia major, sickle- cell thalassemia, sickle- cell disease, multiple myeloma, myelodysplasia, mucopolysaccharidosis, paroxysmal nocturnal hemoglobinuria, non-Hodgkin’s lymphoma, Hodgkin’s disease, severe aplastic anemia, plasma cell leukemia, Niemann-Pick disease, Fanconi anemia, severe combined immunodeficiency, congenital neutropenia, leukocyte adhesion deficiencies, Chediak-Higashi syndrome, osteopetrosis, histiocytosis X, Hurler syndrome, amyloidosis, systemic sclerosis, breast cancer, Ewing's sarcoma, testicular cancer, germ cell tumors, neuroblastoma, medulloblastoma, renal cell carcinoma, nasopharyngeal carcinoma, ovarian cancer, Wilms’ tumor, rhabdomyosarcoma, pancreatoblastoma, and multiple sclerosis. Also, we had 220 cellular therapies for post-myocardial infarction, multiple sclerosis, cirrhosis, head of femur necrosis, Diabetes Mellitus and GvHD treatment. 45 patients were undergone retransplantation in this center.ResultsAbout 78.2% of the patients (2530 of 3237) remained alive between one to 211 months after stem cell transplantation. Nearly, 21.8% (707) of our patients died after stem cell transplantation. The main causes of death were relapse, infection, hemorrhagic cystitis, graft-versus- host disease and etc.ConclusionsIn Iran, HSCT has been successfully adapted in routine clinical care. Recently, new methods such as double cord blood and haploidentical transplantation have been used to treat many life-threatening diseases.

Outcome of Patients Treated with Hematopoietic Stem Cell Transplantation: Results from A Single Center

“…[ 10 ] Despite the significant side effects of HSCT (such as drug side effects, graft versus host disease [GVHD], veno-occlusive disease [VOD], and infection), it still seems to be the only treatment of choice for many malignancies and some nonmalignant diseases. [ 11 ]…”

Worldwide Network for Blood and Marrow Transplantation Recommendations for Establishing a Hematopoietic Cell Transplantation Program, Part I: Minimum Requirements and Beyond

“…Fundamental elements necessary for establishing a transplantation program were developed during these workshops; however, it became evident that these elements were highly dependent on the prevalence of diseases in different regions and on available resources [6][7][8][9]. These factors drive the types of transplantations needed locally and determine what is affordable or economically feasible [10].…”

Resiliency, the Lived Experience of Patients Undergoing Hematopoietic Stem Cell Transplantation

“…It has been considered as a life giving and last resort procedure for many diseases, especially diseases with high mortality, in past decades 1 . Since the prevalence of diseases which need transplantation are high in Iran 2 , 3 , this method caught the attention of health policy makers and the first transplantation center was launched in 1991, and their amount and the amount of transplantation procedures have been increasing ever since 4 .…”