1.Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience.
Wei Sheng Joshua LOKE ; Jean Rachel CATAPIA ; Chay Lee LOW ; Francesca LIM ; Jeffrey QUEK ; Hein THAN ; Yeow Tee GOH ; Yeh Ching LINN ; Colin Phipps DIONG ; Aloysius HO ; William HWANG ; Chung Cheng Jordan HWANG ; Aditi GHOSH ; Liang Pui KOH ; Lip Koon TAN ; Joanne LEE ; Li Mei Michelle POON ; Cheng Kiat Lawrence NG
Annals of the Academy of Medicine, Singapore 2024;54(1):5-16
INTRODUCTION:
Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a curative option for relapse/refractory (R/R) lymphomas that have failed autologous transplantation or for high-risk lymphomas in the upfront setting. We conducted a retrospective analysis on consecutive lymphoma patients who underwent allo-HSCT over a 20-year period (2003- 2022) at Singapore General Hospital and National University Hospital Singapore.
METHOD:
A total of 121 patients were included in the study. Median age was 41 years. Diagnoses include Hodgkin lymphoma (HL, 15%), B-cell non- Hodgkin lymphoma (B-NHL, 34%), T-cell non-Hodgkin lymphoma (T-NHL, 31%) and natural killer T-cell lymphoma (NKTL, 20%). Moreover, 27% of patients had prior auto-haematopoietic stem cell transplanta-tion (auto-HSCT), and 84% received reduced intensity conditioning (RIC). Donor types were matched sibling donor (45%), matched unrelated donor (29%), haploidentical donor (19%) and cord blood (CB, 7%).
RESULTS:
After median follow-up of 56 months, estimated 4-year progression-free survival (PFS) and overall survival (OS) for all patients were 38% and 45%, respectively. Non-relapse mortality (NRM) was 15% at day 100 and 24% at 1 year. On univariate analysis, complete remission status at transplant and RIC confers superior OS. On multivariate analysis, HL was associated with superior OS compared to NHL, whereas matched unrelated donor transplant was associated with significantly inferior OS compared to matched sibling donor.
CONCLUSION
Long-term curative durability was observed with allo-HSCT for patients with relapsed/ refractory lymphomas. This real-world data serves as a valuable historical benchmark for future studies on lymphomas in Singapore and the Asia Pacific region.
Humans
;
Singapore/epidemiology*
;
Adult
;
Male
;
Retrospective Studies
;
Female
;
Hematopoietic Stem Cell Transplantation/methods*
;
Middle Aged
;
Transplantation, Homologous
;
Young Adult
;
Transplantation Conditioning/methods*
;
Lymphoma/mortality*
;
Adolescent
;
Hodgkin Disease/mortality*
;
Aged
;
Lymphoma, B-Cell/mortality*
2.First Feasibility Study and Short-term Outcomes of Laparoscopic-Assisted Anterior Resection in Colorectal Cancer in Malaysia
Henry Chor Lip TAN ; Jih Huei TAN ; Nur Akmalrudin NUR DZAINUDDIN ; Koon Khee CHAN
Annals of Coloproctology 2020;36(2):94-101
Purpose:
The purpose of this study was to demonstrate the feasibility and safety of laparoscopic-assisted anterior resection (LAAR) for colorectal cancer in a local Asian population.
Methods:
This is a retrospective review of all patients with colorectal cancer operated from November 2017 to October 2018. Main variables of interest were demography, type and surgery, length of stay (LOS), and the involvement of proximal and distal doughnut. Postoperative complications were analysed using chi-square or Fisher exact and Mann-Whitney tests.
Results:
There were 23 patients with a mean age of 62.5 ± 12.2 years. The mean time from diagnosis to surgery was 97.1 ± 154.84 days. There were 12 patients in the LAAR group and 11 in the open anterior resection (OAR) group. Duration of surgery was shorter in OAR (129.58 ± 51.38 minutes) compared to LAAR (147.91 ± 39.37 minutes). Mean LOS was shorter in the LAAR group with 5±1.5 days compared to the OAR group of 7.42 ± 4.25 days. However, there was no significant P-value for both duration of surgery (P = 0.322) or LOS (P = 0.87). A total of 3 complications were recorded after OAR and 2 after LAAR. Both groups had clear proximal and distal margins with 16 (12–18.5) harvested lymph nodes in LAAR and 18 (16–22) in OAR, which were equal (P = 0.155).
Conclusion
This study reports a shorter LOS in the minimally invasive group of 2 days with similar oncologic resection outcomes. This shows that LAAR is feasible in Malaysia and has potential outcome benefits.

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