Hematopoietic stem cell transplantation in North Africa: four decades of progress and regional trends (1984-2024).

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a therapy used to treat various malignant and non-malignant conditions and is one of the most resource-demanding medical procedures. In North Africa, the lack of cancer registries has limited insight into the regional progress of HSCT. This study provides an updated overview of the current HSCT landscape in North Africa, tracing its historical evolution and highlighting existing challenges. METHODS: An electronic search was performed in scientific databases (PubMed, ResearchGate, Web of Science and Google Scholar), results of the meetings, conferences, GLOBOCAN, and other registries. Data compilation and statistical analyses concerning HSCT procedures in Morocco, Algeria, Tunisia, Libya and Egypt from 1984 to 2024 were analyzed using Microsoft Excel and IBM SPSS Statistics 25.0. RESULTS: During the study period, 13,129 HSCTs (6990 ASCTs, 5877 allo-HSCTs and 262 haplo-HSCTs) were performed in North Africa at 41 HSCT centers. More ASCTs (53.24%) than allo-HSCTs (44.76%) HSCTs were noted in the region. The most frequent indications were lymphomas, Multiple myeloma, leukemias, aplastic anemia, thalassemia, immune deficiency disorders, Fanconi anemia and other non-malignant disorders. Peripheral blood stem cells, bone marrow and cord blood constitute the main cell source. HSCT costs range from 11,000 to over 111,000 USD and show a moderate negative correlation with the Human Development Index (r = -0.483). CONCLUSION: Despite the efforts made to develop this therapy, HSCT represents only a minority of the therapies used in hematology in North Africa. The cost of sophisticated molecular techniques and newer drugs are sometimes limited factors in the region.