LAUSR

I read with interest the paper by Jaimovich, Lazarus, and Gale, on ‘Challenges and opportunities for hematopoietic cell transplants in resource-poor countries’ [1]. The authors clearly state that two major factors to make more available hematopoietic stem cell transplants (HSCT) for persons living in lowand middle-income countries are the outpatient conduction of the procedures and the use of non-frozen, non-thawed hematopoietic stem cells. To support these observations, they refer to an initial experience of our group, in which 46 patients were given an auto-HSCT and the procedure could be completed fully on an outpatient basis in 83% of transplants and employing non-frozen hematopoietic stem cells (HSC) [2]. Since that experience, published 20 years ago [2], we have increased the number of procedures and, up to now, we have given auto-HSCT on an outpatient basis to 1612 persons, the procedure being completed fully as outpatients in 1567(97%) [3], and employing in all instances peripheral blood-derived non-frozen HSC [3]. These data confirm our initial observations done 20 years ago [2] and indicate that, as a result of gaining expertise, we are now able to avoid hospital admissions in over 97% of the persons given an auto-HSCT. Our data also confirm the usefulness of employing non-frozen HSC in the conduction of autoHSCT; all these modifications to the conventional transplant schedules have resulted in availability of HSCT to a larger number of persons all over the world [4].