Allogeneic Match Unrelated DONOR Trasplantation: First Experience in Colombia

• Objectives: Allogeneic hematopoietic stem cell transplantation (HSCT) is an increasingly common treatment for malignant and non-malignant hematologic diseases. The major limitation to the realization of this type of transplant is access to an HLA-identical donor within the family. Only 30% of patients referred for transplantation will have an appropriate RD; using HLA-identical URD is an alternative for these patients. The aim of this study is to describe the first experience in Colombia with this type of transplant.

• Materials and Methods: Observational case series.

• Results:
From July 1, 2011, have been 89 searches have been started. The most frequent diagnosis acute leukemia (47 ALL, 25 AML). Since there isn´t a national donors registry, searches were performed through NMDP. 26 matched-URD (10/10 or 9/10) were found (29.81%) and 14 transplants have been performed. 8 patients with an URD died before transplantation, 2 lost indication and 2 transplants are waiting.

The median time from the start of the search to finding the donor was 52 days (range 28-240) and once the donor was located it took a median of 67 days (range 36-94) to the infusion.

Transplanted patients were 7 males/7 females, mean age 30 years (2-59), 9 had AML, 3 ALL and 2 SAA. Most leukemias were in first CR (10). Donors were on the majority young (median 37 years; range 21-55), males (8), CMV positive. PBSC were use in 10 cases.

Busulfan-Fludarabine-ATG conditioning regimen was used for leukemia. GVHD prophylaxis consisted of Cs-MTX.

Survival: With a median follow up of 5.83 months (range: 0.86-17.9), 12 of the 14 patients are alive and in remission of their disease (OS 85.7%). One patient died from aGVHD complications and the other due to idiopathic pneumonitis. 2 of the 14 had grade III -IV aGVHD .

• Conclusions: Allogeneic DNF is possible in Colombia and results are the same that would be expected for a similar population with RD. Low rates of success in finding an URD for our Hispanic patients reflects the fact that they represent a minority in world registries and highlight the need for the creation of local registries.