Advances in Hematology (Jan 2024)

Challenges and Outcomes of the First Stem Cell Transplant Program in Tanzania, East Africa

  • Stella Rwezaula,
  • Mbonea Yonazi,
  • Amey Panchal,
  • Ashish Dhoot,
  • Jemy Mathew,
  • Sonu Tony,
  • Sandeep Rao,
  • Peter Muhoka,
  • Samira Mahfudh,
  • Neema Budodi,
  • Mabula Kasubi,
  • Flora Ndobho,
  • Helena Kakumbula,
  • Koga Luhulla,
  • Linda Kapesa,
  • Heri Tungaraza,
  • Sarah Nyagabona,
  • Agnes Shayo,
  • Felister Seleki,
  • Janeth Mtenga,
  • Khadija Mwamtemi,
  • Musa Suko,
  • Isaac Mbughi,
  • Mariana Shirima,
  • Alfayo Mkisi,
  • Rahma Ally,
  • Malselina Kyaruzi,
  • Else Arola Myaka,
  • Johari Matiku,
  • Mariam Nyamwaira,
  • Saranya Nair,
  • Aswathy Asokan,
  • Goutham kumar,
  • Raj Badavath,
  • Hedwiga Swai,
  • Lawrence Museru,
  • B. S. Ajaikumar,
  • Deogratius Beda,
  • Sachin Jadhav

DOI
https://doi.org/10.1155/2024/1937419
Journal volume & issue
Vol. 2024

Abstract

Read online

Introduction. Due to the significant resources involved in creating HSCT programs there is a significant disparity in the availability of this treatment modality between the developed and developing countries. This manuscript details the process and the outcomes of the first HSCT program in East Africa which was started at Muhimbili National Hospital (MNH) in Dar-es-Salaam, Tanzania. Materials and Methods. Information and data were collected on the processes which had been implemented for starting the HSCT program at MNH. The details of the collaborations, training, infrastructure development, and acquisition of the biomedical equipment, as well as the actual process for HSCT, as well as the outcomes of treatment are described. Observations. The project has been detailed in 4 stages for ease of description: Stage 1: Preparatory work which was performed by the Government of Tanzania, as well as the administrators and clinicians from MNH (July 2017-September 2021). Stage 2: Exploratory gap analysis by the teams from MNH and International Haematology Consortium of HCG Hospital, India (HCG-IHC) in October 2021. Stage 3: Activities for closure of gaps (November 2021). Stage 4: Stem Cell Transplantation Camps (November 2021 to March 2022). 11 peripheral blood stem cell transplants were done in two camps, November 2021 (5 patients), and February 2022 (6 patients). 10 patients underwent autologous peripheral blood stem cell transplantation for multiple myeloma and 1 for lymphoma. The median duration of hospital stay was 19 ± 6 days. The median time for neutrophil engraftment, it was on 8.8 ± 0.8 days, and for platelet engraftment was 9.6 ± 2.4 days. Progression-free survival was 100%, and there was no mortality. Conclusion. Commonalities in the socioeconomic challenges in developing countries can be leveraged to create robust HSCT programs in other developing countries.