ABSTRACT
To present our experience of post-transplant infections in allogeneic stem cell transplants at Sheikha Badryia Stem Cell Transplant Centre, Kuwait. Retrospective analysis of 21 consecutive patients with malignant and non-malignant hematological disorders who received a transplant of an unmanipulated bone marrow graft from an HLA-I identical sibling donor from November 2011 to December 2013. Pre-transplant infection surveillance was carried out, and strict prophylaxis against infection was observed. Bone marrow stem | cells were used as the stem cell source. Cyclosporin and methotrexate with or without mycophenolate mofetil / methylprednisolone were used as graft-versus-host disease [GVHD] prophylaxis. The engraftment was monitored with molecular analysis. Survival was calculated from the date of transplant to death or last follow-up. Twenty-one patients received allogeneic stem cell transplants from HLA- matched siblings for various hematological disorders. Twelve patients were female. The median age of the patient cohort was 34 years [range 3-41 years]. All patients and donors were cytomegalovirus [CMV] IgG-positive. Seventeen patients [80.95%] developed febrile episodes in different phases of post-transplant recovery. Post-transplant infections were confirmed in 20 patients [90.2%] on the basis of clinical assessment and microbiological, virological, and histopathological examination. Mortality related to infections and chronic graft versus host disease was one patient [4.8%]. 90% of our patients developed febrile episodes with relatively low culture yield. The majority of infections were treated effectively
ABSTRACT
MALT lymphomas are a group of extranodal indolent lymphomas that usually present as stage IE. To clarify clinical features, treatment alternatives and outcomes, we evaluated 38 patients treated with chemotherapy or radiotherapy between 2000 and 2011. MALT lymphoma patients identified according to WHO classification and treated at KCCC between 2000 and 2011 were included in this study. Demographic and clinical data are presented as means or medians. Overall survival was estimated using the Kaplan-Meier method. Survival rates were compared using the log-rank test. A p value < 0.05 was considered significant. The median age of the patients was 49 years and the male to female ratio was 2:1. Gastric MALT accounted for 63% of all patients and the most common presenting symptom was abdomen pain and dyspepsia. The common extra gastric sites were salivary glands, lung and orbit. 90% of the patients presented with early stage disease. Two patients had history of pre-existing autoimmune disease. Even among patients who had failed prior antibiotic therapy for Helicobacter pylori, treatment with chemotherapy achieved good results with 5 year survival of 80%. MALT lymphomas are indolent neoplasm's with excellent long term outcome. There is no significant difference in survival between gastric and extra-gastric MALT lymphoma