Influence of economical factors on the outcome of the recipients of haematopoietic stem cell allotransplant from related donors

According to the World Bank data, released in the 2008 report, Romania has an upper-middle-income economy. The hematopoietic stem cell transplantation (HSCT) program started in Romania in 2001 and more than 200 transplants (auto and allo) were performed. We analyzed the outcome for 26 patients who underwent an allogeneic hematopoietic stem cell transplantation from matched related donor for acute leukemia (24 patients) and aplastic anemia (2 patients). For 20 of the patients the procedure was performed in Romania and for 6 patients abroad. For both categories the follow-up after transplant was done in hematology units in Romania. The overall survival was 14.69 months, with the longest survival of 60 months and respectively shortest outcome for less than one month. On the 1st November 2008, there were 10 patients alive, between 1 and 60 months from the procedure, with a median survival of 27 months. Sixteen patients died, the median survival being 6 months after transplant. Four out of 16 patients died during the first month after transplant, and a total of 9 patients died during the first 6 months after transplant. The transplant related mortality was 53.84%, 38.46% died due to relapsed disease and 15.38% died of graft failure. For these results, there could be incriminated the irregular and inadequate drugs and reagents supplies in the Romanian Health system, an inefficient follow-up system and registry and home-care facilities deficiencies in Romania. In conclusion, the Gross National Income (GNI) per capita and the Human Development Index (HDI) are very important factors for the outcome of recipients of hematopoietic stem cell.