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

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          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.

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          Hematopoietic stem cell transplantation: a global perspective.

          Hematopoietic stem cell transplantation (HSCT) requires significant infrastructure. Little is known about HSCT use and the factors associated with it on a global level. To determine current use of HSCT to assess differences in its application and to explore associations of macroeconomic factors with transplant rates on a global level. Retrospective survey study of patients receiving allogeneic and autologous HSCTs for 2006 collected by 1327 centers in 71 participating countries of the Worldwide Network for Blood and Marrow Transplantation. The regional areas used herein are (1) the Americas (the corresponding World Health Organization regions are North and South America); (2) Asia (Southeast Asia and the Western Pacific Region, which includes Australia and New Zealand); (3) Europe (includes Turkey and Israel); and (4) the Eastern Mediterranean and Africa. Transplant rates (number of HSCTs per 10 million inhabitants) by indication, donor type, and country; description of main differences in HSCT use; and macroeconomic factors of reporting countries associated with HSCT rates. There were 50 417 first HSCTs; 21 516 allogeneic (43%) and 28 901 autologous (57%). The median HSCT rates varied between regions and countries from 48.5 (range, 2.5-505.4) in the Americas, 184 (range, 0.6-488.5) in Asia, 268.9 (range, 5.7-792.1) in Europe, and 47.7 (range, 2.8-95.3) in the Eastern Mediterranean and Africa. No HSCTs were performed in countries with less than 300,000 inhabitants, smaller than 960 km(2), or having less than US $680 gross national income per capita. Use of allogeneic or autologous HSCT, unrelated or family donors for allogeneic HSCT, and proportions of disease indications varied significantly between countries and regions. In linear regression analyses, government health care expenditures (r(2) = 77.33), HSCT team density (indicates the number of transplant teams per 1 million inhabitants; r(2) = 76.28), human development index (r(2) = 74.36), and gross national income per capita (r(2) = 74.04) showed the highest associations with HSCT rates. Hematopoietic stem cell transplantation is used for a broad spectrum of indications worldwide, but most frequently in countries with higher gross national incomes, higher governmental health care expenditures, and higher team densities.
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            One million haemopoietic stem-cell transplants: a retrospective observational study.

            The transplantation of cells, tissues, and organs has been recognised by WHO as an important medical task for its member states; however, information about how to best organise transplantation is scarce. We aimed to document the activity worldwide from the beginning of transplantation and search for region adapted indications and associations between transplant rates and macroeconomics.
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              Hematopoietic stem cell transplantation in Europe 2014: more than 40 000 transplants annually

              A record number of 40 829 hematopoietic stem cell transplantation (HSCT) in 36 469 patients (15 765 allogeneic (43%), 20 704 autologous (57%)) were reported by 656 centers in 47 countries to the 2014 survey. Trends include: continued growth in transplant activity, more so in Eastern European countries than in the west; a continued increase in the use of haploidentical family donors (by 25%) and slower growth for unrelated donor HSCT. The use of cord blood as a stem cell source has decreased again in 2014. Main indications for HSCT were leukemias: 11 853 (33% 96% allogeneic); lymphoid neoplasias; 20 802 (57% 11% allogeneic); solid tumors; 1458 (4% 3% allogeneic) and non-malignant disorders; 2203 (6% 88% allogeneic). Changes in transplant activity include more allogeneic HSCT for AML in CR1, myeloproliferative neoplasm (MPN) and aplastic anemia and decreasing use in CLL; and more autologous HSCT for plasma cell disorders and in particular for amyloidosis. In addition, data on numbers of teams doing alternative donor transplants, allogeneic after autologous HSCT, autologous cord blood transplants are presented.
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                Author and article information

                Journal
                Bone Marrow Transplant
                Bone Marrow Transplant
                Bone Marrow Transplantation
                Nature Publishing Group
                0268-3369
                1476-5365
                June 2017
                13 March 2017
                : 52
                : 6
                : 811-817
                Affiliations
                [1 ]EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital , Basel, Switzerland
                [2 ]Klinik für Kinder- und Jugendmedizin, Klinikum der Johann-Wolfgang, Goethe-Universität , Frankfurt am Main, Germany
                [3 ]Università Vita-Salute San Raffaele , Milan, Italy
                [4 ]Servicio de Hematologia y Hemoterapia, Hospital Universitario Puerta de Hierro , Madrid, Spain
                [5 ]Hematology Unit, G.Gaslini Children's Institute , Genova, Italy
                [6 ]Children's BMT Unit, Great North Children's Hospital, Royal Victoria Infirmary , Newcastle-Upon-Tyne, UK
                [7 ]Department of Stem Cell Transplantation, University Hospital Eppendorf , Hamburg, Germany
                [8 ]Department of Haematology, University Medical Centre , Utrecht, The Netherlands
                [9 ]Unità Operativa di Ematologia, Ospedale Civile , Ravenna, Italy
                [10 ]St Bartholomew's Hospital, Barts Health NHS Trust , London, UK
                [11 ]Chaim Sheba Medical Center , Tel-Hashomer, Israel
                [12 ]Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital , Sheffield, UK
                [13 ]Department of Pediatric Hematology and Oncology, University Hospital, Collegium Medicum UMK , Bydgoszcz, Poland
                [14 ]Department of Hematology, Hospital Saint Antoine , Paris, France
                Author notes
                [* ]EBMT Activity Survey Office, Division of Hematology, University Hospital Basel , Basel CH-4031, Switzerland. E-mail: jakob.passweg@ 123456usb.ch
                Article
                bmt201734
                10.1038/bmt.2017.34
                5467246
                28287639
                43370fda-97c3-45ab-8920-0730f41348f3
                Copyright © 2017 Macmillan Publishers Limited, part of Springer Nature.

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/

                History
                : 16 December 2016
                : 10 January 2017
                : 12 January 2017
                Categories
                Special Report

                Transplantation
                Transplantation

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