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Abstract Hematopoietic stem cell transplantation (HSCT) has become the standard of care for many patients with defined congenital or acquired disorders of the hematopoietic system or with chemosensitive, radiosensitive, or immunosensitive malignancies. Non-Hodgkin lymphoma (NHL) is a heterogeneous group of hematologic malignancies, known to be associated with chronic inflammatory diseases such as Sjögren syndrome, celiac disease, and rheumatoid arthritis. Autologous stem cell transplantation (SCT) has frequently been used in these patients because these lymphomas are generally very sensitive to chemotherapy and radiation therapy. The percentage of allogeneic HSCT for lymphoma has markedly increased over recent years due to the introduction of reduced-intensity conditioning allogeneic HSCT. The postulated advantages of an allo- HSCT include the use of a tumor-free graft and immune-mediated graft-versuslymphoma effects, but the survival benefit is usually offset by a nonrelapse mortality rate. As seen with other transplant indications, any reduction in relapse achieved with alloHSCTis offset by mortality attributable to the treatment itself. The development of less intensive but highly immunosuppressive conditioning regimens that rely on possible graft-versus-tumor effects have increased the number of patients who are candidates for allografts, including those who relapse after auto-HSCT. The study is aimed to assess the clinical outcome in Egyptian patients diagnosed with lymphomas subjected to hemopoietic allogeneic stem cell transplantation from Human Leukocyte Antigen identical sibling donors This is A Retrospective study, carried out on 35 patients with Lymphoma, at Bone Marrow Transplantation Unit at Nasser Institute Hospital, from May 1997 to August 2018. The main results of the study revealed that: Among the studied cases (n=39) there were 33 (84.6%) males and 6 (15.4%) females and there were 21 (53.8%) with age less than 30 and 18 (46.2%) with age more than 30; the mean age was 28.09 ± 12.07 with range (6-53). Among the studied cases there were 9 (23.1%) with H.D, 13 (33.3%) with NHL, 5 (12.8%) with Burkett’s lymphoma, 10 (25.6%) with Lymphoblastic Lymphoma, 1 (2.6%) with H.D and 1 (2.6%) females. Among the studied cases there were 10 (25.6%) P and 29 (74.4%) A Among the studied cases the mean TLC 500 was 11.46 ± 3.95 with range (0-21), the mean TLC 1000 was 13.0 ± 4.43 with range (0-22), the mean Plat. 25000 was 11.92 ± 4.81 with range (0-26), the mean Plat. 100000 was 11.82 ± 8.01 with range (0-33) and the mean Abs. was 16.18 ± 12.30 with range (0-61). According to Acute/0-1 there were 35 (89.7%) not acute, 3 (7.7%) GIT and 1 (2.6%) GIT/Skin, according to AGVHD/2-4 there were 31 (79.5%) No and 8 (20.5%) Yes, according to chronic/ (Denovo, ST) there were 37 (94.9%) No and 2 (5.1%) Yes, according to CGVHD/ 2ry (progr) there were 37 (94.9%) No and 2 (5.1%) Mild, liver and according to chronic GVHD-Lim/Ext there were 32 (82.1%) No and 7 (17.9%) Yes. Among the studied cases the mean Hospital Stay was 41.31 ± 16.55 with range (21-105) and the mean CD34 Cells was 7.06±3.0 with range (2.9-16). Among the studied cases the mean RBCs was 2.41 ± 4.60 with range (0-28) and the mean Plat. was 2.69 ± 4.43 with range (0-26). Among the studied cases there were 11 (28.2%) Bu/Cy, 10 (25.6%) TBI/CY, 13 (33.3%) FLU/ALK and 5 (12.8%) FLU/BU/post Cy.Among the studied cases there were 39 (100%) with CSA, 21 (53.8%) with MTX, 14 (35.9%) with MMF and 2 (5.1%) with STD. According to CMV there were 25 (64.1%) NO and 14 (35.9%) yes, according to D.O relapse there were 34 (87.2%) No and 5 (12.8%) Yes, according to Mortality there were 14 (35.9%) Died and 25 (64.1%) alive. Among the studied cases there were 5 (12.8%) with HCV Ab, 5 (12.8%) with HCV PCR, 2 (5.1%) with HBsAg, 9 (23.1%) with HBsAB, 2 (5.1%) with HBcAb, 1 (2.6%) with HIV, 33 (84.6%) with CMV IgG, 1 (2.6%) with CMV IgM, 7 (17.9%) with Tox. IgG and 0 (0%) with Tox. IgM. According to Kaplan-Meier survival curve the mean overall survival was 20.497 and the median was 78.400 with 0% percent. There was no significant difference between the AGVHD/2–4 yes and no groups as regard Sex, Age, Diagnosis, A.P, TLC 500, TLC 1000, Plat. 25000 or Plat. 100000. There was significant difference between the AGVHD/2–4 yes and no groups as regard Hospital Stay and RBCs. There was no significant difference between the AGVHD/2–4 yes and no groups as regard Abs., Acute/0-1, chronic/ (Denovo, ST), CGVHD/ 2ry (progr), chronic GVHD-Lim/Ext, CD34 Cells or Plat. There was significant difference between the AGVHD/2–4 yes and no groups as regard MMF, STD, CMV, Mortality, HCV Ab and HCV PCR. There was no significant difference between the AGVHD/2–4 yes and no groups as regard Cond., MTX, D.O relapse, HBsAg, HBsAB, HBcAb, HIV, CMV IgG, CMV IgM, Tox. IgG or Plat. Based on our results we recommend for further studies n larger patients and longer period of follow up to emphasize our conclusion. |