Assesment of Upper Egypt Experience in Autologous Bone Marrow Transplantation of Patients With Hematological Malignancies: A Cohor Study

Overview

Autologous hematopoietic stem cell transplantation (ASCT) is an important treatment for eligible patients with hematological malignancies, particularly multiple myeloma and relapsed lymphoma. Although advances in transplantation have improved outcomes, complications such as infections, febrile neutropenia, mucositis, delayed engraftment, organ toxicity, and relapse remain significant. This study aims to evaluate clinical outcomes and patient satisfaction after ASCT and identify factors associated with favorable or unfavorable transplant outcomes.

Hematological malignancies are a heterogeneous group of neoplastic disorders arising from the bone marrow and lymphoid tissues, including multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma, and selected leukemias. Despite substantial advances in chemotherapy, targeted therapies, and immunotherapy, relapse remains a major cause of treatment failure and disease-related mortality. Autologous hematopoietic stem cell transplantation (ASCT) has become an integral component of treatment for eligible patients by allowing the administration of high-dose chemotherapy followed by reinfusion of the patient's own hematopoietic stem cells to restore bone marrow function, thereby improving disease control and survival outcomes. ASCT is considered the standard consolidation therapy for transplant-eligible patients with multiple myeloma and an effective salvage treatment for relapsed or refractory Hodgkin lymphoma and selected aggressive non-Hodgkin lymphomas. Advances in stem cell mobilization, cryopreservation techniques, conditioning regimens, antimicrobial prophylaxis, and supportive care have significantly improved engraftment rates while reducing transplant-related morbidity and mortality. However, complications such as febrile neutropenia, severe infections, mucositis, delayed hematopoietic recovery, organ toxicity, and disease relapse continue to adversely affect patient outcomes and quality of life. Assessment of transplantation outcomes is essential to evaluate the effectiveness and safety of ASCT in routine clinical practice. Several factors, including patient age, disease status at transplantation, performance status, conditioning regimen, CD34⁺ cell dose, and post-transplant complications, may influence survival and treatment success. Therefore, this study aims to assess the clinical outcomes of ASCT and patient satisfaction among patients with hematological malignancies, as well as to identify factors associated with favorable and unfavorable transplant outcomes, thereby contributing to improved patient selection and optimization of transplant strategies.