Non-cryopreserved peripheral blood stem cells autologous transplantation in multiple myeloma: Bicentric study.

OBJECTIVES: The objective of this study is to evaluate the toxicity of autologous transplantation of non-frozen peripheral blood stem cells in Moroccan patients with multiple myeloma. MATERIAL AND METHODS: This was a bicentric retrospective study conducted in the Clinical Haematology Department of Mohammed V Military Teaching Hospital and at the Al Madina Clinic in Casablanca. The study period was from January 2015 to June 2019. All patients with multiple myeloma who had undergone an autologous peripheral stem cell transplant without freezing were included. Mobilisation was performed with lenograstim alone and the collected stem cells were stored for 24-48hours in a blood bank refrigerator at a temperature of 4°C. After standard conditioning with high-dose melphalan, the peripheral blood stem cells were reinjected 24 h following conditioning. RESULTS: Over the study period, 55 patients received an autologous transplant using non-frozen peripheral blood stem cells. The median richness of the CD34 cells collected was 4.5×106 CD34/kg (range: 2-12.2). The time required for neutrophil recovery was 12 days (range: 7-19). The time required for platelet recovery was 14 days (range: 9-32). The mortality rate within 100 days post-transplant was 3.6%. We did not observe any cases of graft failure. CONCLUSION: Our study finds good feasibility and low toxicity of autologous peripheral stem cell transplantation without freezing in patients with multiple myeloma.

HLA typing and haematopoietic stem cell transplantation in the histocompatibility unit of the Ibn Sina University Hospital in Rabat (Morocco).

PURPOSE OF STUDY: This study focuses on the search for a suitable related HLA-matched donor of haematopoietic stem cells in the context of allogeneic transplantation in Morocco. The aim of this work is to establish whether the related donor can meet graft needs in Moroccan patients. PATIENTS AND METHODS: 429 families (429 recipients and 965 donors) benefited from HLA typing, using microlymphocytotoxicity, polymerase chain reaction-sequence specific primer and/or high-resolution polymerase chain reaction-specific sequence oligonucleotide. RESULTS: The recipients and donors are mostly men over 18 years of age. In total, 86.8% of the recipients have between 1 and 3 donors who are 96% of the collaterals. Malignant haemopathies account for 54% of allograft indications. Benign haemopathies are more frequent than malignant in children, whereas the profile is reversed in adults. Fifty percent of recipients have an HLA identical donor in their siblings and 42% and HLA haplo identical donor. The HLA typing of the recipients and the donors reveals very large polymorphism of the population. CONCLUSION: The related donor of haematopoietic stem cells represents an important source of grafts but will not be able to satisfy all the needs of Morocco. The creation of national unrelated voluntary donors will open up new possibilities for recipients who do not have a compatible donor within his relatives.

Postpartum infections in a tropical environment: The experience of the infectious diseases department at Fann Teaching Hospital of Dakar (Senegal).

To describe the epidemiology, clinical characteristics, and outcomes of infections in postpartum women admitted to the infectious diseases department at Fann Teaching Hospital. This retrospective descriptive study examined the records of women admitted for infectious diseases within 42 days after childbirth during the five-year period (2007-2011). Data were collected from medical files and analyzed with Sphinx plus2 V5 software. In all, 54 women were admitted for infections during the postpartum period. Their mean age was 27.4 ± 6.2 years. Fifty women (93%) had had vaginal deliveries. The average interval from delivery to admission was 15.4 ± 11.0 days. Tuberculosis (14 cases), vaginitis (13 cases), and severe malaria (7 cases) were the most frequent infectious diseases. The average duration of hospitalization was 12.1 ± 9.0 days. The mortality rate was 30%, with the main causes of death tuberculosis (25 %) and severe pneumonia of unknown causes (25 %). Tropical diseases remain frequent during the postpartum period, with a high lethality rate, as this study shows. Early diagnosis during pregnancy and better follow-up after delivery should be the best ways of reducing morbidity and mortality from these infections.