Immediate and late results of autologous hematopoietic stem cell transplantation: the experience of the P. A. Herzen Moscow Oncology Research Institute (2020–2025)

Background. The key goal of autologous hematopoietic stem cell transplantation (auto-HSCT) is to overcome bone marrow failure, which complicates high-dose chemotherapy. In 2024, 2,790 HSCTs were performed in Russia, 61 % of which were autologous and 39 % allogeneic. Transplant activity in the country has increased by 46 % over the past 5 years.

Aim. To evaluate the immediate and long-term outcomes of auto-HSCT in patients with hematologic malignancies treated over the past 6 years (2020–2025) in the High-Dose Chemotherapy Department with the Bone Marrow Transplantation Unit at the P. A. Herzen Moscow Oncology Research Institute.

Materials and methods. This retrospective observational study included data from 187 patients who underwent auto-HSCT at the P. A. Herzen Moscow Oncology Research Institute. For the analysis, patients were divided into 3 nosologic groups: multiple myeloma (MM) – 127 (68 %), non-Hodgkin’s lymphoma (NHL) – 31 (16.6 %), and classical Hodgkin’s lymphoma (cHL) – 29 (15.4 %) patients. The median age ranged from 33 to 59 years depending on the nosology. The study assessed the parameters of CD34⁺ cell mobilization, conditioning regimens, hematological toxicity, overall survival (OS), and progression-free survival (PFS). Survival analysis was performed using the Kaplan–Meier method.

Results. A total of 203 auto-HSCT procedures were performed, including 16 (7.9 %) tandem transplants for MM. The median of collected CD34⁺ cells was 8.1 × 10⁶ / kg in MM, 9.4 × 10⁶ / kg in cHL, and 7.6 × 10⁶ / kg in NHL. Hematopoiesis was restored within comparable time frames in all groups (median agranulocytosis duration was 9–12 days). With a median follow-up of 20–25 months, the 2-year PFS rates were 91.6 % (MM), 92.0 % (cHL), and 81.6 % (NHL); 2-year OS was 96.3 % (MM), 100 % (cHL), and 85.6 % (NHL). Patients with MM showed a significant improvement in the response after transplantation (the proportion of complete responses increased from 9.4 to 61.4 %; p = 0.003).

Conclusion. The results of our single-center study demonstrate the high efficacy and acceptable safety profile of auto-HSCT, comparable to global data. Further development of high-dose therapy programs, optimization of mobilization, and the introduction of new maintenance therapy regimens are promising areas for improving treatment outcomes for patients with hematological malignancies in the Russian Federation as a whole.