Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants

J R Passweg, H Baldomero, P Bader, C Bonini, S Cesaro, P Dreger, R F Duarte, C Dufour, J H F Falkenburg, D Farge-Bancel, A Gennery, N Kröger, F Lanza, A Nagler, A Sureda, M Mohty, European Society for Blood and Marrow Transplantation (EBMT), J R Passweg, H Baldomero, P Bader, C Bonini, S Cesaro, P Dreger, R F Duarte, C Dufour, J H F Falkenburg, D Farge-Bancel, A Gennery, N Kröger, F Lanza, A Nagler, A Sureda, M Mohty, European Society for Blood and Marrow Transplantation (EBMT)

Abstract

A record number of 39,209 HSCT in 34,809 patients (14,950 allogeneic (43%) and 19,859 autologous (57%)) were reported by 658 centers in 48 countries to the 2013 survey. Trends include: more growth in allogeneic than in autologous HSCT, increasing use of sibling and unrelated donors and a pronounced increase in haploidentical family donors when compared with cord blood donors for those patients without a matched related or unrelated donor. Main indications were leukemias, 11,190 (32%; 96% allogeneic); lymphoid neoplasias, 19,958 (57%; 11% allogeneic); solid tumors, 1543 (4%; 4% allogeneic); and nonmalignant disorders, 1975 (6%; 91% allogeneic). In patients without a matched sibling or unrelated donor, alternative donors are used. Since 2010 there has been a marked increase of 96% in the number of transplants performed from haploidentical relatives (802 in 2010 to 1571 in 2013), whereas the number of unrelated cord blood transplants has slightly decreased (789 in 2010 to 666 in 2013). The use of donor type varies greatly throughout Europe.

Figures

Figure 1
Figure 1
Relative proportions of indications for an HSCT in Europe in 2013. (a) Proportions of disease indications for an allogeneic HSCT in Europe in 2013. (b) Proportions of disease indications for an autologous HSCT in Europe in 2013.
Figure 2
Figure 2
Transplant rates in Europe (= total number of HSCT per 10 million inhabitants) by participating country, showing 15-year trends 1998–2013. (a) Allogeneic transplant rates per 10 million population in 1998–2013 (b) Autologous transplant rates per 10 million population in 1998–2013.
Figure 3
Figure 3
Absolute numbers by transplant and donor type 1998–2013. (a) Absolute numbers of allogeneic and autologous HSCT in Europe in 1998–2013. (b) Absolute numbers of sibling donor and unrelated donor HSCT in Europe 1998–2013. (c) Absolute numbers of haploidentical and cord blood HSCT in Europe 1998–2013.
Figure 4
Figure 4
Disease indications by donor type in 2013. (a) Proportions of disease indications in 2013 for sibling donor HSCT. (b) Proportions of disease indications in 2013 for haplo-identical donor HSCT. (c) Proportions of disease indications in 2013 for unrelated donor HSCT. (d) Proportions of disease indications in 2013 for cord blood HSCT.
Figure 5
Figure 5
Transplant rates for sibling donor, unrelated donor, haploidentical donor and cord blood HSCT in Europe in 2013 for the 15 countries with the highest transplant rates.

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