ABSTRACT
Introduction: Algeria is a country of 40.4 million inhabitants and half of which is under 30 years. In Algeria, Health-care insurance covered, 90% of the population. Health care is free and it is supported by the Ministry of Health. 16 university hospitals exist in Algeria and only two [Algiers and Oran] practicing bone marrow transplant. Adult hematologic malignancies account for 10% [about 4000 new cases/year] of the malignancy affecting in most cases young patients under 65 years of age. In 2016, 270 transplants were performed in total [Algiers + Oran], including 149 allografts [related donor transplants: 99%] and 121 autografts. 98% of transplants are done in adults and only 2% in children with cord blood transplants. In summary for the two transplant centers, the predominant types of transplantation performed are allogeneic transplant in 55% and autologous transplant in 45%. The particularity of EHU1st November in Oran, is the use of non-cryopreserved stem cells. Stem cell was mobilized using G-CSF alone and the grafts were kept in a conventional blood bank refrigerator at +4 °C until reinfusion on day 0. The outcome with non-cryopreserved stem cells are the same as those with cryopreserved stem cells and we conclude that autologous transplant with non cryopreserved hematopoietic stem cells [HSC] is a simple, effective and safe method and the cryopreservation is not necessary in our work conditions in developing countries. The projects are achieving the autograft in all University Hospitals with non cryopreserved HSC, achieving a center allograft in the east of the country and the development of bone marrow transplantation in children
Conclusion: Currently in Algeria, the number of transplantation is insufficient and the development of new transplant centers is essential. In the future, we hope to implement the National Society of Bone Marrow transplant and also the National recipient registry and Donor registry in Algeria
ABSTRACT
We evaluated the efficacy and safety of non-cryopreserved storage of autologous hematopoietic stem cells with no post-transplant granulocyte colony-stimulating factor [G-CSF] support in adult patients undergoing autologous stem cell transplantation [ASCT] for multiple myeloma [MM]. Retrospective review of patients undergoing ASCT from May 2009 to July 2011. Autologous stem cell were mobilized using G-CSF. Leukapheresis to harvest stem cells was performed on day -2 and -1. The grafts were kept in a conventional blood bank refrigerator at 4°C until reinfusion on day 0. The conditioning regimen consisted of melphalan 200 mg/m[2] in all patients. The post-chemotherapy myeloablative phase was managed without growth factors. Between May 2009 to July 2011, 54 adults with MM were treated in our center in Oran. The median age at ASCT was 55 years [range, 35-65]. There were 37 males and 1 7 females. The median harvested CD34+ cell count was 3.60x10[6]/kg [range, 1.90 to 10.52]. All patients had neutrophil engraftment on the median of day 10 [range, 6-17] and platelet transfusion independence on the median of day 13 [range 9-24]. In the 47 evaluable patients the median post-transplant overall survival had not been reached; the estimated overall survival at 30 months was 93.8% [0.05%], and the estimated disease-free survival at 27 months was 93.6% [0.05%]. High-dose chemotherapy and ASCT using non-cryopreserved stem cells and no G-CSF support is safe and feasible in the treatment of MM under our work conditions in developing countries
ABSTRACT
In Algeria, the incidence of hematologic malignancies has been difficult to estimate for many years. Today, many hematological centers, including 14 university hospitals, have been developed in the entire north and have useful epidemiological data pertinent to acute myeloid leukemia [AML]. We studied the incidence of AML and its subtypes, age distribution, geographic distribution and trends in the rate of diagnosis over the last 5 years in Algeria. Secondary goals were to study trends of referral of AML cases from various regions to specific centers to assess the needs for health infrastructure and change of current practices. Retrospective analysis of nationwide survey of all adult cases of AML [>16 years] diagnosed between 1 January 2006 and 31 December 2010. A survey form was distributed to all departments of hematology at the 15 participating centers. The 1426 cases of AML diagnosed during the study period represented an annual incidence of 0.91/100 000 persons with a male to female [M/F] ratio of 1:16 and a median age of 45 years [range, 16-82 years]. Nationally, 20% of cases AML were diagnosed in the whole western region of the country, 47% in the central and 33% in the east. There was a trend of continuous increase in the rate with age and in the rate of diagnosis over the last 5 years. The most common subtype was M2, followed by M4 and M5. An overall increase in the number of AML patients diagnosed nationwide over the last five years indicates a need for additional health care resources including curative and therapy-intense strategies, such as stem cell transplant facilities to optimize outcome. The relatively younger age of patients compared to the Western countries may be due to the demographic composition of our population