Abstract
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a critical therapeutic option for patients with specific malignancies. This study aimed to elucidate the epidemiological profile of HSCT to address existing gaps in understanding regional trends and outcomes over 14 years at a single center. METHODS: This retrospective cohort study analyzed the medical records of all patients who underwent HSCT at the Bone Marrow Transplant (BMT) ward of Urmia Imam Khomeini Hospital in Iran, from December 2010 to December 2024. Comprehensive evaluations of clinical and demographic characteristics were conducted during the pre-HSCT period. Data collection focused on post-transplant clinical outcomes and complications, adhering to standardized definitions to ensure unbiased estimates. RESULTS: This study examined 280 HSCT patients, predominantly men (59.6%), with a mean age of 45.85 years (SD, 13.70). Autologous HSCT comprised 76.43% of cases, followed by allogeneic (21.78%) and haploidentical donor HSCT (1.79%). The primary indications were multiple myeloma (48.9%) and acute myeloid leukemia (24.3%). The median overall survival (OS) was 77 months (95% CI: 62.05-91.95), and a 5-year OS rate of 54%. The mean disease-free survival (DFS) was 86.21 months (95% CI: 74.62-97.81), with a 5-year DFS rate of 67%. The cumulative incidence of acute graft-versus-host disease (acute GVHD) was 59.2% at 100 days post-transplant (61% in allogeneic and 40% in haploidentical patients), with skin being the most affected organ (78.12%). Last, 20.2% of the mortality in the total population with available acute GVHD was attributed to having grades 3 and -4 acute GVHD. CONCLUSION: These findings underscore the viability of hematopoietic stem cell transplantation in resource-limited settings, highlight areas for improvement in post-transplant care-particularly regarding severe acute GVHD-and offer valuable insights to guide clinical practice and health policy in similar regional centers.