Abdel-Rahman F, Hussein Aa, Rihani R, Hlalah Oa, El Taani H, Sharma S, Nserat T, Sarhan Mm
The Bone Marrow and Stem Cell Transplantation Program, King Hussein Cancer Center, Amman, Jordan.
Bone Marrow Transplant. 2008 Aug;42 Suppl 1:S89-S91. doi: 10.1038/bmt.2008.126.
Bone marrow and stem cell transplantation in Jordan has been performed since the 1990s, but the first comprehensive program was established at King Hussein Cancer Center (KHCC) in March 2003. The program, in addition to other health care institutions in Amman, serves approximately 5.6 million Jordanians. Also, we treat several patients per year from neighboring Arab countries. The program at KHCC performs an average of 80 transplants per year. During the past 4 years 320 patients received transplants at KHCC; 26% of them received an autologous graft and 74% allogeneic grafts. Of the allogeneic grafts 91% were taken from matched family members, 6.7% were haploidentical from one of the parents, and 2.3% were from an unrelated donor or umbilical cord blood. The actuarial overall survival among all patients has been around 65%. The most common indication for transplantation at KHCC was leukemia/MDS followed by benign nonmalignant hematological/immune deficiency/metabolic disorders, with thalassemia major being the most common among this group. The cost of SCT is variable and depends on many factors including the type of transplant and the attending post-transplant complications. The average charge for autologous transplant (both adults and pediatrics) is 24,695 JD (one JD equals 1.42 USD), and the average charge for allogeneic transplant (both adults and pediatrics) excluding haploidentical transplant is 46,787 JD. We have not noticed any peculiar patterns of complications following BMT; however, we have seen a high incidence of chronic GVHD following minitransplant with fludarabine and single-dose TBI (Seattle protocol). At the inception of the program, invasive fungal infection mainly related to building construction, and central line complications were significant. Measures implemented to control such complications were successful to a large extent. We report our results to the EBMT group and we are accredited as an unrelated transplantation center. Although from a young program, our group has presented abstracts to international conferences.
自20世纪90年代以来，约旦就开展了骨髓和干细胞移植，但首个综合性项目于2003年3月在侯赛因国王癌症中心（KHCC）设立。该项目与安曼的其他医疗机构一起，为约560万约旦人提供服务。此外，我们每年还治疗来自周边阿拉伯国家的几名患者。KHCC的项目每年平均进行80例移植手术。在过去4年里，有320名患者在KHCC接受了移植；其中26%接受了自体移植，74%接受了异体移植。在异体移植中，91%取自匹配的家庭成员，6.7%来自父母一方的单倍体相合移植，2.3%来自无关供体或脐带血。所有患者的精算总生存率约为65%。KHCC最常见的移植适应症是白血病/骨髓增生异常综合征，其次是良性非恶性血液学/免疫缺陷/代谢紊乱，其中重型地中海贫血是该组中最常见的。干细胞移植的费用各不相同，并取决于许多因素，包括移植类型和移植后出现的并发症。自体移植（成人和儿童）的平均费用为24,695约旦第纳尔（1约旦第纳尔等于1.42美元），异体移植（成人和儿童，不包括单倍体相合移植）的平均费用为46,787约旦第纳尔。我们没有注意到骨髓移植后并发症有任何特殊模式；然而，我们发现采用氟达拉滨和单剂量全身照射（西雅图方案）进行小型移植后慢性移植物抗宿主病的发生率很高。在项目启动时，侵袭性真菌感染主要与建筑施工有关，中心静脉导管相关并发症也很严重。为控制此类并发症而采取的措施在很大程度上取得了成功。我们将我们的结果报告给欧洲血液和骨髓移植组（EBMT），并且我们被认可为一家无关供体移植中心。尽管我们的项目开展时间不长，但我们团队已在国际会议上发表了摘要。
