Document Detail


Allogeneic hematopoietic SCT performed in non-HEPA filter rooms: initial experience from a single center in India.
MedLine Citation:
PMID:  18794872     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In developing countries, it is important to ascertain the safety of performing allogeneic hematopoietic SCT (HSCT) in single rooms without high-efficiency particulate air (HEPA) filters. We present our experience of performing 40 such transplants from July 2004 to November 2007. Source of stem cells was peripheral blood in 33, bone marrow in six and combined in one. G-CSF started from day +1. The indications were SAA-18, CML-7, AML-7, ALL-2, myelodysplastic syndrome-2 and thalassemia major-4. The median age was 19 years (range 2.2-46) with 29 male and 11 female participants. Antibacterial and antifungal prophylaxis was administered along with conditioning, and at the onset of fever, systemic antibiotics were started. Antifungal agents were added if fever persisted for 3 days. Median time for neutrophil engraftment was 10 days (range 8-17). Fever occurred in 38 (95%) for a median of 5 days (range 1-38), and blood cultures were positive in seven (17.5%). Systemic antibiotics were used in 95% and antifungals in 57.5% cases. The 30-day mortality was nil, and 100-day mortality was 1 (2.5%). After day 100, there were eight fatalities (20%) due to chronic GVHD-3, relapse-2, graft rejection-2, disseminated tuberculosis and aspergillosis-1. Our experience suggests that allogeneic HSCT can be safely performed in non-HEPA filter rooms in India.
Authors:
R Kumar; R Naithani; P Mishra; M Mahapatra; T Seth; T K Dolai; R Bhargava; R Saxena
Publication Detail:
Type:  Journal Article     Date:  2008-09-15
Journal Detail:
Title:  Bone marrow transplantation     Volume:  43     ISSN:  1476-5365     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-28     Completed Date:  2009-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  115-9     Citation Subset:  IM    
Affiliation:
Department of Hematology, All India Institute of Medical Sciences, Delhi, India. rajat.kumar@cancercare.mb.ca
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Infective Agents / therapeutic use
Child
Child, Preschool
Female
Filtration / instrumentation*
Hematopoietic Stem Cell Transplantation / adverse effects,  methods*
Humans
India
Male
Middle Aged
Opportunistic Infections / prevention & control
Patient Isolation
Postoperative Complications / prevention & control
Treatment Outcome
Ventilation / methods*
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Infective Agents

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