Publication

Abstract : Background Hematopoietic Stem Cell Transplant (HSCT) is conventionally performed in HEPA fi ltered room as patient has to pass through critical period of 1-2 weeks of severe neutropenia. This reduces potential bacterial and fungal infections which would have signifi cant impact on early transplant related mortality. Aim To evaluate short and long term outcome of HSCT performed in various hematological patients, in non-HEPA fi ltered single rooms Methodology We reviewed medical records of 66 HSCT performed in non-HEPA fi ltered single rooms, over last 5 years, at our institution retrospectively with respects to different variables and analyzed systematically. G-CSF was given to all from D+1. 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. Results We present our single centre experience of 66 allogenic stem cell transplants performed over period of last 5 years. All these transplants were performed in non-HEPA fi ltered single room. Source of stem cells were PBSC-56, BM-9, Combined-1. The indications were SAA-30, CML10, AML-8, ALL-5, Biphenotypic AL-1, Thalassemia-9, and MDS-3. The median age was 24 years (range 2.2-46) with 16 females and 55 males as participants. Median time for neutrophil engraftment was 10 days (range 8–17). Fever occurred in 59 (89%) for a median of 5 days (range 1–38), Systemic antibiotics were used in 88% and antifungal in 52% cases. The 30-day mortality was 3(4.7%), and 100-day mortality was 5 (7.8%). After day 100, there were seventeen fatalities (26.5%) due to chronic GVHD-5, relapse-2, graft rejection-2, infections like disseminated tuberculosis-1 and aspergillosis-3, VOD-2, platelet refractoriness leading to IC bleed-2. Conclusion Our experience suggests that allogeneic HSCT can be safely performed in non-HEPA fi lter rooms in India.