Haematopoietic stem cell transplantation in Hong Kong

This journal suppl. is conference proceedings of the 2009 Chinese Blood & Marrow Transplantation Forum by Hong Kong Society of Haematology (HKSH) and Chinese Society of Blood and Marrow Transplantation (CSBMT)The first case of haematopoietic stem cell transplant (HSCT) was performed at the Bone Marrow Transplant Center, Queen Mary Hospital (QMH) in 1990. Since then three more transplant centres have been established: Prince of Wales Hospital (1991) mainly in paediatric transplant, Queen Elizabeth Hospital (1995) and Tuen Mun Hospital (2006) in adult autologous transplant. Up to the end of 2008, a little over 2000 transplants have been performed in Hong Kong, and QMH takes up about 85% of the total number of cases. A unified HSCT registry in Hong Kong is desirable and is yet to be established. At QMH, by the end of 2008, a total of 1708 transplant procedures have been performed with 83% (1417) being first-time transplants and the rest (291, 17%) are repeat transplants mostly for relapsed patients. The numbers of male and female patients are 955 and 753, respectively. The median age is 35.4 years (range, 3 months to 67 years) with 85.8% of the transplants performed in adults (>18 years). The type of donor includes 34% autologous, 1% syngeneic, 38% related allogeneic and 27% unrelated allogeneic. The top five indications of the first-time transplants are acute myeloid leukaemia (25.8%), chronic myeloid leukaemia (15.9%), lymphoma (14.6%), acute lymphoblastic leukaemia (14.5%), and myeloma (8.6%). With the development of peripheral blood stem cell collection, in recent years it is performed in 50% of the allogeneic and 80% of the autologous cases. Bone marrow harvest in autologous cases is only for patients who fail peripheral blood stem cell mobilisation. Transplant outcomes are reported to the Center for International Blood and Marrow Transplant Research and long-term survivals are in general comparable to international standard.published_or_final_versionThe 2009 Chinese Blood & Marrow Transplantation Forum, Hong Kong, 27-28 February 2009. In Hong Kong Medical Journal, 2009, v. 15, suppl. 3, p. 17-2

A comparison of TBI and non-TBI conditioning regimens in patients undergoing matched-unrelated bone marrow transplantation

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Changes in haematopoiesis in bone marrows primed with haematopoietic growth factors before allogeneic bone marrow transplantation: an interim analysis

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Ex vivo expansion of peripheral blood haematopoietic stem cells: preclinical studies

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Involvement of macrophage migration inhibitory factor (MIF) in graft-versus-host disease (GvHD)

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Nitrite/nitrate levels in patients after stem cell transplant

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Sustained and repeated response of relapsed acute promyelocytic leukaemia to intravenous or oral arsenic trioxide

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Helper T-lymphocyte precursor frequency (HTLPf) predicts the occurrence of graft-versus-host disease (GVHD) and disease relapse after allogeneic bone marrow transplantation

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Non-myeloablative allogeneic peripheral stem cell transplantation for multiple myeloma

Objective. To present an institution's 2-year experience of non-myeloablative allogeneic stem cell transplantation among Chinese patients. Design. Retrospective study. Setting. Bone marrow transplantation unit at a university hospital, Hong Kong. Patients. Ten patients with multiple myeloma who received non-myeloablative allogeneic stem cell transplantation between March 2000 and October 2002. Intervention. Fludarabine (90 mg/m 2) and total body irradiation (300 cGy) were given as conditioning regimens, followed by non-myeloablative allogeneic stem cell transplantation. Main outcome measures. Engraftment, regimen-related toxicity, treatment-related mortality (in the first 100 days), incidence of graft-versus-host disease, chimerism, disease response, and survival rate. Results. All 10 patients had active disease before transplantation. The donors were eight human leukocyte antigen-matched siblings, a mismatched sibling, and a matched daughter. Satisfactory engraftment before day 21 was achieved without early treatment-related mortality. Five patients developed full donor chimerism by day 28 and three other patients had 100% donor chimerism by day 100. Acute graft-versus-host disease developed in six patients (five with grade III and one with grade IV disease), and chronic graft-versus-host disease developed in eight patients (four with extensive disease). Complete remission and partial response were achieved in three and four patients, respectively. Three patients did not respond to treatment, and one case of relapse was observed. Only one patient, who had shown a partial response, received donor lymphocyte infusion; seven patients received thalidomide for graft-versus-host disease with or without graft-versus-myeloma effect. All patients were alive after a median follow-up of 1 year. Conclusion. Non-myeloablative allogeneic stem cell transplantation for multiple myeloma is effective, has low toxicity, and results in low treatment-related mortality. Studies of more cases with longer follow-up durations are required.published_or_final_versio

Clinical characteristics and risk factors of herpes zoster after bone marrow transplantation

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