Overall and Free-Event Survival of Patients Taken to Hematopoietic Stem Cell Transplantation in a Colombian Reference Center

INTRODUCTION:

Hematopoietic cell transplantation is a standard care procedure, frequently curative where no other treatment is an option.

OBJETIVE:

Describe the clinical and sociodemographic characteristics of patients taken to HSCT at Fundación Oftalmológica de Santander - Clínica Carlos Ardila Lülle (FOSCAL) in Santander, Colombia, and determine the overall survival (OS) and free-event survival (FES) of patients at 100 days, 1 year and 4 years, according to the base illness state

MATERIALS AND METHODS:

Observational descriptive open prospective cohort study of consecutive patients who underwent HSTC at FOSCAL (Santander, Colombia). Information on sociodemographic and clinical characteristics was collected from medical records between November of 2009 and July of 2015. Normality analysis was made through Shapiro-Wilk test, and survival function was estimated with Kaplan and Meier. This protocol was reviewed and approved by the committee of ethic, investigation or its equivalents of Universidad Autónoma de Bucaramanga and FOSCAL.

RESULTS:

56 patients constituted the total sample, 50% were women with an average age of 46 (±15 years). Most frequent indications for HCT were multiple myeloma (41%), lymphoma (37.5%) and acute leukemia (12.5%). According to the type of transplant made and its indication, autologous transplant occupied the first place (85.7%) along with multiple myeloma (48%). In allogeneic transplant the most frequent cause of HCT was acute leukemia (75%). The sources of hematopoietic progenitors in 98% of the transplants were taken from peripheral blood. Nineteen patients died (33.9%). The principal cause of death was related to the primary illness, while three deaths were directly related to the HCT. OS at day 100 was 96.4 (CI95%, 86.2 - 99.1), at 1 year, 85.4 (CI95%, 73.03 - 92.4) and at 4 years, 68.6 (CI95%, 52.4 - 80.3). FES at day 100 was 94.5 (CI95%, 83.9 - 98.2), at 1 year, 86.8 (CI95%, 74.4 - 93.2) and at 4 years, 61.0 (CI95%, 45.1 - 73.6). OS and FES at 4 years of autologous HCT was 71.5 (CI95%, 72.6 - 83.1) and 62.6 (CI95%, 45.6 - 75.6) respectively, and OS and FES at 4 years of allogeneic HCT was 50.0 (CI95%, 8.05 - 82.6) and 48.6 (CI95%, 22.6 - 81.6) respectively. There were no significant differences in OS and FES according to the state of the pretransplant disease: OS of 69.5 (CI95%, 38.8 - 87.0) and FES of 57.5 (CI95%, 30.1 - 77.5) for multiple myeloma, 65.0 (CI95%, 40.3 - 81.5) and 57.8 (CI95%, 33.2 - 76.2) for lymphoma and 47.6 (CI95%, 7.5 - 80.8) and 45.7 (CI95%, 6.9 - 79.5) for acute leukemia.

CONCLUSIONS:

The indications of HCT in our center are similar to published international literature. The principal cause of death was primary illness and a low incidence of transplant related death was registered (1.57%). OS and FES are similar to international registries according to primary disease diagnosis.