Hematopoietic Stem Cell Transplantation Without the Use of Blood Components by the Patient's Choice: Experience of 2 Brazilian Centers.

Autor: da Silva RL; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil. Electronic address: roberto@biosanas.com.br., da Silva LAM; Faculty of Medical Sciences, Santa Casa de Sao Paulo, Sao Paulo, SP, Brazil., Geraldo BLDSS; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Simões AA; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Almeida MSS; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Fernandes PA; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Simões CM; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Russo FT; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Okada LY; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Cavalcante JN; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Lopes MAVF; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil., Macedo RA; Faculty of Medicine, Santa Marcelina, Sao Paulo, SP, Brazil., Macedo MCMA; Department of Hematology and Hematopoietic stem cell transplant, Brazilian Intitute for Cancer Control (IBCC), Sao Paulo, SP, Brazil; Department of Hematology and Hematopoietic stem cell transplant, São Camilo Hospital, Sao Paulo, SP, Brazil; Medical Services Bio Sana's, Sao Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2020 Mar; Vol. 26 (3), pp. 458-462. Date of Electronic Publication: 2019 Oct 25.
DOI: 10.1016/j.bbmt.2019.10.018
Abstrakt: Hematopoietic stem cell transplantation (HSCT) has been used to treat many malignant and nonmalignant hematologic conditions; however, the use of HSCT in patients who refuse blood transfusions has rarely been described in the literature, and no data have been published concerning haploidentical HSCT without the use of blood products. The aim of this study is to describe the experience of a Brazilian group in performing 21 HSCTs without the use of blood components in the first 100 days after transplantation, which is the period corresponding to the greatest risk of toxicity for this procedure. We developed 21 HSCTs without transfusion support in 19 patients admitted to 2 Brazilian transplantation centers. The patients were subjected to stem cell mobilization and different conditioning regimens. No mortality related to the procedure occurred among the transplant recipients. The global survival rate after 100 days, which is the period related to the immediate toxicity of HSCT, was 94.7%, and the median duration of follow-up was 980 days, with an overall survival rate of 68.4%. Thus, refusal of blood transfusion is not an absolute contraindication for HSCT. This therapy is feasible in specific situations when the patient clearly expresses a desire to avoid blood transfusions and when favorable clinical conditions are achievable with strict, specialized medical monitoring.
(Copyright © 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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