Background:Donor selection strategies for allogeneic hematopoietic cell transplantation (HCT) have evolved with the increasing use of haploidentical transplantation. However, contemporary patterns of donor and stem cell source selection according to disease category in the Asia-Pacific (AP) region remain insufficiently characterized. Methods:Aggregated data from the APBMT Activity Survey 2022-2023 were analyzed to evaluate donor type and stem cell source distributions for allogeneic HCT. Donors were categorized as HLA-identical sibling, haploidentical (including other related donors), or unrelated donor. Stem cell sources were classified as bone marrow (BM), peripheral blood (PB), cord blood (CB), or mixed graft sources. Malignant and non-malignant diseases were compared, and disease-specific analyses were performed for acute myeloid leukemia, myelodysplastic syndrome/myeloproliferative neoplasms, severe aplastic anemia, and hemoglobinopathy. Sensitivity analyses excluding data from China were conducted. Results:Donor selection differed between malignant and non-malignant diseases, with haploidentical donors accounting for approximately 45%-60% of allogeneic HCTs, followed by unrelated donors (20%-30%) and HLA-identical sibling donors (15%-25%). Regarding stem cell source, PB was the predominant source across disease categories, accounting for approximately 60%-70% of allogeneic HCTs. BM accounted for approximately 5%-17% of transplants, with somewhat higher use in non-malignant diseases. CB accounted for approximately 10%-12% of transplants in malignant diseases and 3%-4% in non-malignant diseases. These patterns were consistent in disease-specific analyses; however, exclusion of China resulted in a relative decrease in haploidentical transplantation and an increase in unrelated donor use, particularly in malignant diseases, as well as a marked reduction in mixed graft sources with a corresponding increase in bone marrow use. Despite these shifts, the overall predominance of peripheral blood as the stem cell source and the disease-specific trends were maintained. Conclusions:Across AP region, donor and stem cell source selection for allogeneic HCT demonstrates modest but consistent disease-specific differences, reflecting adaptation of transplantation strategies to disease context in contemporary clinical practice.
The present study was done to determine the response and survival analysis in upfront hypomethylating agents-Venetoclax (HMA-Ven) regimen in Acute Myeloid Leukemia (AML) and Myelodysplastic Syndrome (MDS) patients unfit for chemotherapy. This cross sectional study was conducted at National Institute of Blood Diseases and Bone Marrow Transplantation (NIBD-BMT), Karachi, Pakistan from January 2020 to December 2023. The primary endpoint was overall response rate (ORR) defined as Complete Remission (CR), Complete Count Recovery (CCR), Partial Count Recovery (PCR) with or without blasts. Secondary outcomes included median overall survival (OS) and event-free survival (FFS) analysed by Kaplan-Meier method. A total of 33 (22 AML and 11 MDS) patients were included. AML patients had median age of 62 and 48years was observed in MDS. After 4 cycles of HMA + Ven, ORR was reported as 93.7
Discoveries of driver mutations in myeloproliferative neoplasms (MPNs) have filled the diagnostic gap however there are non-driver genes which play an important role in the phenotype of the disease. This study is the first to evaluate the molecular landscape of non-driver genes in MPNs patients from Pakistan. A sample of fourteen MPNs patients (eight essential thrombocythemia, five primary myelofibrosis and one polycythemia vera) was investigated by the next generation sequencing, using 333 cancer genes panel. Chi square test was run in SPSS 22.0 to check association of non-driver genes with sub categories of MPNs. Among 333 oncology related genes, possible pathogenic variations were identified in 2.1
Breast cancer is recognized as a global issue affecting millions of women with a greater impact on their lives. Worldwide, breast cancer is among the most prevalent forms of the disease. Throughout their lives, 12% of American women will experience a breast cancer diagnosis, and in 2017, more than 250,000 new cases were reported to the medical community. This study was conducted in a cross-sectional approach retrospectively in a tertiary care hospital in Karachi, Pakistan, in which data of all types of cancer patients were gathered from 1st January 2023 – 31st December 2023 in a pre-designed/translated data collection form. Initial analysis was piloted in the form of descriptive statistics such as percentages and frequencies. Chi-square tests and Monte Carlo tests were used to analyze breast cancer occurrence and risk factor associations, considering p-value <0.05 as statistically significant. Following the analysis, an incidence of 11.51 and a prevalence of 13.36 were calculated for 2023. confirms the occurrence of breast cancer among middle-aged women (Mean age 48.67±12.14 years) at an advanced stage in Karachi, Pakistan. A highly statistically significant correlation was detected between hormonal status and stage (p < 0.01), type of breast cancer and stage (p < 0.01), gender and habits (p < 0.01), and ethnicity and habits (p < 0.01), respectively. On the other hand, marital status was not correlated to the stage of breast cancer (p = 0.913). No significant association was found between ethnicity and segregated hormone receptor status. These findings suggest the need for interventions such as awareness programs, lifestyle adoption, and breastfeeding /hormonal usage training programs to prevent diagnosis postponements, awareness, and prevention, thus reducing disease load. Also, the unavailability of data highlights the need for a centralized national cancer control body promoting the entry of updated data of these patients across the private and public sectors.
