Hematopoietic cell transplantation outcomes in public centers in Brazil: analysis of the Brazilian Registry of Hematopoietic Cell Transplantation and Cellular Therapy, 2012–2024

This study provides a national overview of hematopoietic cell transplantation (HCT) outcomes in the Brazil’s public healthcare network, using data consolidated in the Brazilian Registry of Hematopoietic Cell Transplantation and Cellular Therapy (RBTCH-TC). A total of 5,923 first HCTs performed between 2012 and 2024 across 19 public centers were analyzed. Median follow-up among survivors reached 24.5 months, reflecting recent improvements in follow-up completeness and data reliability within the registry. Overall survival, relapse, and non-relapse mortality (NRM) rates were generally consistent with international benchmarks, despite the resource limitations characteristic of a publicly funded system. NRM was concentrated in the first year after allogeneic HCT, whereas relapse remained the predominant cause of late mortality across both autologous and allogeneic procedures. Acute graft versus-host disease (GVHD) was more frequent among recipients of mismatched related and unrelated donors, while chronic GVHD occurred more often in matched related donor transplants. These findings highlight the complexity of transplant care in the public setting and underscore the importance of standardized data collection, integration across centers, and long-term surveillance to support continuous quality improvement. Strengthening national collaborative initiatives such as the RBTCH-TC remains essential for guiding evidence-based strategies and improving patient outcomes throughout Brazil’s public transplant network.