A 14‐year retrospective analysis of indications and outcomes of autologous haemopoietic stem cell transplantation in regional Queensland: a single‐centre experience

Abstract

Background The Townsville Hospital is a tertiary hospital in North Queensland with one of the largest regional transplant centres in Australia, performing primarily autologous haemopoietic stem cell transplants (HSCT) for various haematological malignancies. Aims This single‐centre, retrospective, observational study aims to describe the activity and outcomes of autologous HSCT at The Townsville Hospital between 2003 and 2017 to verify safety standards. Methods Patient‐level data were collected, including demographics, frequency and indication for transplant, conditioning, current clinical status and cause of death. Key outcomes included overall survival, non‐relapse mortality, incidence of therapy‐related neoplasm and causes of death. Progression‐free survival in the multiple myeloma (MM) subgroup was also assessed. Results There were 319 autologous HSCT in 286 patients, with a median age of 58 years (range 14–71 years); 62% of patients were male. Indications for transplantation were: MM 53.7%, non‐Hodgkin lymphoma 29.4%, Hodgkin lymphoma 5.0% and other 11.9%. Causes of death were: disease progression/relapse (65.2%), second malignancy (17.0%), infection (9.8%) and other (8.0%). Non‐relapse mortality was 1.2% (95% confidence interval 0.4–3.0) and 3.2% (1.7–5.7) at 100 days and 1 year, respectively, post‐HSCT. Overall survival at 2 years was 81.0% (73.8–86.4) for MM and 69.6% (58.8–78.1) for non‐Hodgkin lymphoma. The median progression‐free survival in the MM cohort was 3.3 years. Conclusion The Townsville Hospital transplant centre provides an important transplant service in regional Queensland, with outcomes comparable to national data. We reported a relatively high rate of second malignancy as a cause of death.

Outpatient autologous stem cell transplantation in Royal Hobart Hospital, Tasmania: a single‐centre, retrospective review in the Australian setting

“…With the caveats of a retrospective study, our experience is relevant. The indications for transplantation and patient demographics of our series are congruent with national figures 12,13 . The 30‐ and 100‐day mortality rates were low at 2.2% and 4.4% in BEAM ( n = 4) and 0.8% in MEL ( n = 1), comparable with published data 14,15 .…”

“…The indications for transplantation and patient demographics of our series are congruent with national figures. 12,13 The 30-and 100-day mortality rates were low at 2.2% and 4.4% in BEAM (n = 4) and 0.8% in MEL (n = 1), comparable with published data. 14,15 While both early deaths within BEAM patients occurred in the outpatient group, both patients had been inpatients for at least 48 h before requiring ICU level care, therefore an admission for Outpatient autograft in Tasmania conditioning is unlikely to alter this outcome.…”

Activity and outcomes of autologous stem cell transplantation in the private sector in Australia

“…Little is known about ASCT outcomes in the private sector, which varies in organisational, reimbursement and healthcare delivery models to the public healthcare system 5 . A thorough analysis of the activity and outcomes of Icon's ASCT clinical and laboratory programme will benefit numerous stakeholders.…”

“…Little is known about ASCT outcomes in the private sector, which varies in organisational, reimbursement and healthcare delivery models to the public healthcare system. 5 A thorough analysis of the activity and outcomes of Icon's ASCT clinical and laboratory programme will benefit numerous stakeholders. This includes ensuring there is a safe and effective transplant programme in the private sector, an assessment of the private sector's contribution to ASCT, identifying potential variations in patient selection, and allowing for a data-driven design of effective policy interventions to maintain Australia's dual health system for highly complex therapies.…”