Objective: Unrelated stem cell transplant (SCT) is an option for patients who have no available related donor, and a transplant is the best treatment modality for them. We aimed to document our bone marrow bank activity to define the proficiency and unmet requirement.
Methodology: We retrospectively screened the medical records from electronic files. The data from 2016 until 2019 were collected. The statistical analysis of the patients who presented for stem cell transplant, and of the healthy donors for demographic features, stem cell counts, stem cell sources, diagnosis, survival, GVHD, CMV, and HLA matches were performed using the SPSS 21.0.
Results: A total of 640 patient and donor pairs enrolled in the study. Most of the patients were adults (n=359). Patients’ mean age was 26.77±21.06 years (range 0–74), and donor's 31.9±9.6 years (range 24–75). The gender distribution was as male to female 377/263 for patients and 333/304 for the donors. The primary (43%) SCT indication was acute leukemia. Preference of stem cell sources was as follows; peripheral blood (n=450; pediatric/adult: 137/313), bone marrow (n=161; pediatric/adult: 130/31), and cord blood (n=8; pediatric/adult: 8/0). In 21 cases, donor leukocytes were provided (pediatric/adult: 6/15). The total HLA tissue group compatibility between the patient and the donor was *10/10 in 47.8% of cases, *9/10 in 51.3% cases, and *8/10, *5/6, *6/8 in 9% of cases. The survival analysis showed no statistical difference between 10/10 and 9/10 HLA matched transplants. The sex match between patient and donor and the stem cell source has no significant effect on GVHD development (p>0.005 and p: 0.226, respectively).
Conclusion: The outcome of SCT is effected mainly by HLA tissue compatibility, age, sex, and blood group match. Istanbul Bone Marrow Bank, with the HLA tissue typing laboratory, works internationally and provides stem cells since 1999 for SCT. With the collaboration of SCT centers, donor and stem cell source selection, and transfer is getting faster. The SCT outcome information is also a modulating factor to improve the quality of work. We, therefore, periodically document our activity and pursue to find a solution for getting better.
