Outcome of allogeneic haematopoietic stem cell transplantation in aplastic Anaemia

To analyze factors associated with survival, rejection and graft versus host disease in aplastic anaemia patients undergoing allogeneic haematopoietic stem cell transplantation [SCT] from HLA matched sibling donors. Analytical study. Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan from July 2001 to June 2010. Consecutive aplastic anaemia [AA] patients undergoing haematopoietic stem cell transplantation from HLA-matched sibling donors at this centre were included in this study. Potential factors affecting overall survival, rejection, disease-free survival and graft versus host disease were analyzed. Survival analysis was done by Kaplan-Meier method. Cox regression model was applied for multivariate analysis. Ninety male and thirty-five female patients with AA were included in the study. Median age was 18 years. Conditioning regimens used were cyclophosphamide [Cy] plus antilymphocyte globulin [ALG] or antithymocyte globulin [ATG], fludarabine [FLU] +Cy+ATG, Campath 1-H +Cy in 89, 30 and 6 cases respectively. GVHD prophylaxis used was ciclosporin [CSA] plus prednisolone and short methotrexate in 81 while 44 received CSA plus prednisolone. At a median follow-up of 1185 days OS and DFS were 84% and 78% respectively. Factors associated with better OS were male sex, Flu/Cy/ATG conditioning and use of bone marrow as stem cell source. Flu/Cy/ATG conditioning regimen, bone marrow as stem cell source and CSA, prednisolone and short methotrexate regimen were associated with better survival in AA

Relapsed diffuse large B-cell lymphoma treated by reduced-intensity allogeneic stem cell transplantation with donor lymphocyte infusion

A 42 years old male with relapsed diffuse large B-cell lymphoma was given second-line chemotherapy followed by reduced intensity allogeneic stem cell transplantation from HLA matched brother. Twelve weeks posttransplant, his disease relapsed evidenced by the appearance of lymphoma cells in the peripheral blood and declining donor chimerism. Donor lymphocyte infusion was given that induced complete lymphoma remission. The patient is well 3 years posttransplant with his disease in complete remission

audit of guided Percutaneous needle aspiration of liver abscess

A prospective study was undertaken to determine the results of needle aspiration under ultrasound guidance together with amoebicidal and antibiotic therapy. The study reports experience of 50 cases of liver abscess admitted in the medical wards of Capital Hospital, Islamabad from January 1994 to December 1999. In all these cases, diagnosis was based on clinical findings, abdominal ultrasound appearance, bacteriological cultures and serological tests. 86% of these were males and 14% were females. Age range was 10 years to 69 years. Majority of the patients had amoebic liver abscess. None of the patients developed any complication requiring surgical exploration. There was no mortality in this study. It is concluded that needle aspiration of liver abscess under ultrasound guidance together with amoebicidal and antibiotic therapy is safe, quick and effective method of treating liver abscess, than blind procedure or open surgery