Outcome of Stem Cell Transplantation from Low resources set up Bone Marrow Transplantation unit

Abstract

In Thailand, despite the improvement of care for malignancies, some groups of patients have failed to respond to standard treatment and faced recurrence of diseases. Thailand is an endemic area of several genetic disorders and thalassemia has been a budgetary burden for the Royal Thai government.

Hematopoietic stem cell transplantation (HSCT) is a definite cure for several hematological diseases including malignancies, thalassemia and severe aplastic anemia. Bone marrow transplantation (BMT) was found promising in spite of low resources. Thirteen cases of BMT (10 cases for autologous and 3 cases for allogeneic transplantations) were performed and outstanding outcomes were reported in this study. The median follow-up time was 11 months (2 months – 47 months range). Both disease-free survival and overall survival were 100% with 10 months median disease-free survival time. One case had acute GVHD grade I with no evidence of chronic GVHD. Moreover, the median cost of autologous BMT was US$10,601 dollars (US$7,113 – 14,872 range) and the median cost of allogeneic BMT was US$ 15,153 dollars (US$ 13,808 – 16,924 range) which were more economical than the BMT costs in the developed countries. Maintaining basic necessities such as HEPA filter system with positive pressure gradients room air and lab checkup as much as necessary can both reduce expenses and prevent complications.