Use of haploidentical stem cell transplantation continues to increase: the 2015 European Society for Blood and Marrow Transplant activity survey report

J R Passweg, H Baldomero, P Bader, C Bonini, R F Duarte, C Dufour, A Gennery, N Kröger, J Kuball, F Lanza, S Montoto, A Nagler, J A Snowden, J Styczynski, M Mohty, J R Passweg, H Baldomero, P Bader, C Bonini, R F Duarte, C Dufour, A Gennery, N Kröger, J Kuball, F Lanza, S Montoto, A Nagler, J A Snowden, J Styczynski, M Mohty

Abstract

Hematopoietic stem cell transplantation (HSCT) is an established procedure for many acquired and congenital disorders of the hematopoietic system. A record number of 42 171 HSCT in 37 626 patients (16 030 allogeneic (43%), 21 596 autologous (57%)) were reported by 655 centers in 48 countries in 2015. Trends include continued growth in transplant activity over the last decade, with the highest percentage increase seen in middle-income countries but the highest absolute growth in the very-high-income countries in Europe. Main indications for HSCT were myeloid malignancies 9413 (25%; 96% allogeneic), lymphoid malignancies 24 304 (67%; 20% allogeneic), solid tumors 1516 (4%; 3% allogeneic) and non-malignant disorders 2208 (6%; 90% allogeneic). Remarkable is the decreasing use of allogeneic HSCT for CLL from 504 patients in 2011 to 255 in 2015, most likely to be due to new drugs. Use of haploidentical donors for allogeneic HSCT continues to grow: 2012 in 2015, a 291% increase since 2005. Growth is seen for all diseases. In AML, haploidentical HSCT increases similarly for patients with advanced disease and for those in CR1. Both marrow and peripheral blood are used as the stem cell source for haploidentical HSCT with higher numbers reported for the latter.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Relative proportion of indications for HSCT in Europe in 2015. (a) Proportions of disease indications for allogeneic HSCT in Europe in 2015. (b) Proportions of disease indications for autologous HSCT in Europe in 2015.
Figure 2
Figure 2
The rise and fall in absolute numbers of allogeneic HSCT for CLL in Europe 1990–2015.
Figure 3
Figure 3
Change in the absolute numbers of haploidentical and cord blood HSCT in Europe 1990–2015. (a) Change in donor selection from cord blood HSCT to haploidentical HSCT. (b) Increase in the use of haploidentical donors by main indication group. (c) Haploidentical HSCT by AML early disease and advanced disease. (d) Haploidentical HSCT by cell source; bone marrow versus peripheral blood. (e) Trend in the use of unrelated cord blood HSCT by main indication group 2006–2015.
Figure 4
Figure 4
Effect of income group on changes in transplant activity and transplant rates 2005–2015. (a) Percentage increase in transplant activity for allogeneic HSCT (top left), increase in transplant rates for allogeneic HSCT (bottom left). (b) Percentage increase in transplant activity for autologous HSCT (top right), increase in transplant rates for autologous HSCT (bottom right).

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Source: PubMed

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