IntroductionAt Hiwa Cancer Hospital (Sulaymaniyah, Iraqi Kurdistan) after the center was
started by a cooperative project in June 2016, autologous transplantation
was developed.Patients and MethodsTo develop the project, the capacity-building approach was adopted, with
on-site training and coaching of personnel, educational meetings, lectures,
on-the-job training, and the implementation of quality management
planning.ResultsHere, we report initial results of peripheral-blood stem-cell mobilization
and collection of the first 27 patients (age 12 to 61 years; 19 males and 8
females; multiple myeloma, n = 10; plasma cell leukemia, n = 1; Hodgkin
lymphoma, n = 12; non-Hodgkin lymphoma, n = 3; and acute myeloid leukemia, n
= 1). Only three (11.5%) of 26 patients experienced a failure of
mobilization. A median of 6.1 × 106/kg CD34-positive cells
per patient were collected (range, 2.4 to 20.8), with two apheretic runs.
Twenty-four patients underwent autologous transplantation. All but one
transplantation engrafted fully and steadily, with 0.5 and 1.0 ×
109/L polymorphonucleates on day 10.5 (range, 8 to 12) and
day 11 (range, 9 to 15), respectively, and with 20 and 50 ×
109/L platelets on day 13 (range, 10 to 17) and day 17
(range, 2 to 44), respectively. More than 95% of patients are projected to
survive 1 year after autograft.ConclusionThese data are the result of an Italian effort to establish in Iraqi
Kurdistan a leading center for hemopoietic stem-cell transplantation. The
capacity building approach was used, with on-site training and coaching as
instruments for the development of provider ability and problem solving.
With future limitations for immigration, this method will be helpful,
especially in the field of high-technology medicine.