الفهرس 
INTRODUCTION & AIM OF WORKOnly 14 pages are availabe for public view
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Abstract
This study is non-randomized, pilot study that aims at the descriptive analysis of the first four cases of relapsing NHL undergoing high-dose chemotherapy and autologous stem cell transplantation at our center. Patients in this arm of comparable patients continuing to receive salvage chemotherapy using one of standard regimens (e.g. DHAP, Appendix # 6). This comparison will focus on the presentation of the different new technicalities and clinical findings related to the HDC procedure, as compared to those encountered in the conventional salvage arm.
The current study included 15 patients with relapsing aggressive NHL. Disease responsiveness was initially assessed by 2 cycles of the DHAP salvage chemotherapy protocol. Five patients were excluded either due to lack of disease responsiveness (2 patients) or grade 3 renal toxicity (2 patients) or both (1 patient). The remaining 10 patients were admitted to the study arms with 4 patients were admitted to the study arms with 4 patients in the HDC and PSCT arm and 6 patients in the conventional salvage DHAP arm. Patients were followed up for a minimum of 6 months.
After a medium follow up of 6 months (6-19), all patients in the HDC arm relapsed after a medium of 6 months (range 6-19) and 2 patients in the DHAP arm relapsed after 2 and 6 months from the end of salvage.
The average cost of HDC and PSCT procedure was 47,206 L.E. and for full course of DHAP (medium of 5 cycles, including supportive care) it was 15,858 L.E.
Future HDC studies should include a large number of patients before statistically significant results can be obtained.
Cost reduction remains an important issue in the transplantation field in our country. This can be achieved through a number of points. The utilization of conventional salvage regimens in mobilizing stem cells can preclude the need for the administration of special mobilizing regimens. The delayed administration of hamatopoietic growth factors in the post-reinfusion period was not associated with delayed engraftment or increased patient’s morbidity or mortality. The utilization of out patient procedures during some of the transplantation during some of the transplantation steps would also minimize hospital stay and hence the costs.