Comparison of morbidity and mortality rates in patients undergoingallogeneic stem cell transplantation with myeloablative and nonmyeloablative conditioning regimens

Comparison of Morbidity and Mortality Rates in Patients Undergoing Allogeneic Stem Cell Transplantation with Myeloablative and Non-Myeloablative Conditioning Regimens This study aims to compare the efficacy and safety profiles of MAC and NMAC regimens in terms of morbidity, mortality, relapse rates, and survival outcomes. The study was initiated after obtaining approval from the Clinical Research Ethics Committee of Akdeniz University Faculty of Medicine (approval number 113 and date 05.03.2024). Between June 10, 2017, and May 5, 2023, 98 patients with malignant or benign hematological diagnoses who underwent allogeneic bone marrow transplantation at the Adult Bone Marrow Transplantation Unit were included in the study. It is a retrospective cross-sectional descriptive study. Of the patients, 62.2% (n=61) were male, and 37.8% (n=37) were female. The mean transplantation age of the patients was 44.57±12.97 years, and the mean age of the donors was 40.55±13.17 years. 55.1% (n=54) of the patients were diagnosed with AML, and 25.5% (n=25) were diagnosed with ALL. 89.7% of the patients achieved a complete response before transplantation. 43.9% of the patients died. Among the surviving 55 patients, 90.9% were in remission, while 9.1% had relapsed. 77.6% of the patients were classified as MAC, while 22.4% were classified as RIC. Significant differences were observed between the MAC and RIC groups in terms of transplantation age (p<0.001), diagnosis (p<0.001), neutrophil engraftment time (p=0.008), platelet engraftment time (p<0.001), presence of antifungal treatment (p=0.004), and donor age (p=0.045). According to the OS analysis results, with a calculated median survival of 49.517 months, the presence of GVHD within 100 days and the absence of a pre-transplant response were associated with significant differences in survival (p<0.05). Prognostic factors affecting PFS included the presence of GVHD within 100 days and the absence of a pre-transplant response. These findings provide a multidimensional assessment of allogeneic stem cell transplantation, addressing patient selection, conditioning regimens, complication management, and post-transplantation survival factors, and emphasize the significance of this area in alignment with existing literature. Keywords: Internal Medicine, Allogeneic Stem Cell Transplantation, Conditioning Regimens (MAC and RIC)