Hematopoietic stem cell transplantation in Iran: 1991 through 2010
Introduction: This review reports the current results of hematopoietic stem cell transplantation (HSCT) in patients who had received transplantation in the Hematology-Oncology and SCT Research Center, Tehran, Iran. Methods: In Iran, from 1991 through 2010, a total of 3170 hematopoietic stem cell transplantation have been carried out. The male/female patient ratio was 1909/1261 with a median age of 23 years (range: 4 months-71 years). The most common transplanted disorders were acute myelogenous leukemia (799 patients; 25.2%), thalassemia major (500 patients; 15.8%) and acute lymphoblastic leukemia (447 patients; 14.1%). The donor types for 2147 allogeneic HSCT patients were 2007 (93.5%) human leukocyte antigen (HLA) matched- identical siblings, 66 (3.1%) HLA matched (other relatives), 52 (2.4%) HLA mismatched sibling/other relatives and 22 (1%) unrelated donors; also 16 (0.5%) of transplanted patients had syngeneic twins as donor. Results: There were 2147 cases which had received allogeneic HSCT and 1007 cases which had received autologous HSCT. The number of allogeneic and autologous HSCT patients had increased during that time, but the allogeneic to autologous ratio remained constant. Out of 2147 allogeneic HSCT cases, there were 1730 (80.6%) cases of peripheral blood, 370 (17.2%) cases of bone marrow, and 13 (0.6%) combined peripheral blood and bone marrow cases and 34 (1.6%) cord blood cases as product types. Of the 1007 autologous patients with the first HSCT, 937 (93%) received peripheral blood, 65 (6.5%) bone marrow and 5 (0.5%) mixed bone marrow and peripheral blood as stem cell sources. Conclusion: Hematopoietic stem cell transplantation is a choice treatment for many malignant, nonmalignant and genetic diseases. In Iran, HSCT has been successfully adapted in routine clinical care. Recently, new methods have been used, for example double cord blood and haploidentical transplantation.