Allogeneic bone marrow transplantation in the developing world: experiencefrom a center in India

We describe our experience of setting up an allogeneic BMT program at the C hristian Medical College Hospital, Vellore over a period of 13 years, from October 1986 to December 1999. Two hundred and twenty-one transplants were performed during this period in 214 patients, with seven patients undergoin g second transplants. Indication for BMT were thalassemia major - 106 (48%) , CML - 30, AML - 35, ALL - 10, SAA - 22, MDS - six and six for other misce llaneous disorders. The mean age of this patient cohort was 15.6 years (ran ge 2-52). Graft-versus-host disease of grades III and IV was seen in 36 pat ients (17%) and this was the primary cause of death in 20 patients (9.2%). All patients and donors were CMV IgG positive. Sepsis was the primary cause of death in 16 patients (7.4%), 10 bacterial, four fungal and two viral, O ne hundred and ten of this series of patients are alive and disease free (5 0%) with a median follow-up of 24 months (range 2-116). These results are c omparable to those achieved for patients with similar disease status in tra nsplant units in the Western world and cost a mean of US$15 000.