Current status of hematopoietic stem cell transplantation in Taiwan

Abstract

In Taiwan, hematopoietic SCT (HSCT) has been used to treat patients with hematological diseases since 1983. Since then, more than 2200 patients have undergone HSCT in 15 large hospitals. The disease entities included acute leukemia in 37% of cases, non-Hodgkin's lymphoma in 26%, CML in 10%, multiple myeloma in 7% and severe aplastic anemia in 6%. The conditioning regimens used were mainly myeloablative (84% of cases). Nonmyeloablative regimens were fludarabine-based. The average age of allogeneic recipients was at least 10 years older than those in the era before their application. The grafts of all patients were derived from peripheral blood in 85% of cases, BM in 13% and cord blood (CB) in 2%. Forty percent of HSCT patients received autologous grafts, whereas more than 25% of allogeneic HSCT patients received grafts from unrelated donors, and overall, there were more than 200 Taiwan HSCT recipients. Currently, CB has been used successfully in pediatric patients with thalassemia major and also in adult patients with hematological malignancy. After transplantation, there was a relatively lower prevalence of acute GVHD. However, a relatively higher proportion of hepatitis B carriers in the recipients had led to a higher incidence of viral reactivation and clinical hepatitis, which was dramatically decreased following lamivudine prophylaxis. In conclusion, HSCT has been successfully adapted to routine clinical care in Taiwan. Several important findings contributing to the progress of HSCT in the past two decades have also been noticed on this island.

Impact of Donor Characteristics and HLA Matching on Survival of Chinese Patients with Hematologic Malignancies Undergoing Unrelated Hematopoietic Stem Cell Transplantation

“…The use of stem cells from HLA-matched unrelated volunteer donors (MUDs) is an accepted option for patients without a matching sibling donor, with comparable outcomes to matched sibling donor HSCT [1]. In Taiwan, MUDs account for approximately 25% of graft sources, and this percentage is increasing [2]. Although the benefits of HSCT are well established, the high incidence of complications associated with this procedure requires continued investigation to improve stem cell engraftment, reduce treatment toxicities, avoid graft-versus-host disease (GVHD), and increase the available pool of suitable donors.…”

Hematopoietic SCT activity in Asia: a report from the Asia-Pacific Blood and Marrow Transplantation Group

“…Recent reports on HSCT from Asian countries suggest the progress of HSCT in this region. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] However, no comprehensive picture of the current state of HSCT in Asia has been obtained. The Asia-Pacific region consists of countries with various ethnic, economical and social backgrounds.…”

Risk of osteoporosis and pathologic fractures in cancer patients who underwent hematopoietic stem cell transplantation: a nationwide retrospective cohort study

“…In contrast to data on the short-term effects of bone loss, data on the long-term effects of bone loss after HSCT are limited [7, 9, 13–15]. In Taiwan, HSCT has been a common therapy for hematopoietic diseases and malignancies since 1983 [16]. Approximately 200 transplantations have been performed annually in recent years, and more than 2200 patients have undergone HSCT until 2008 [16].…”

“…In Taiwan, HSCT has been a common therapy for hematopoietic diseases and malignancies since 1983 [16]. Approximately 200 transplantations have been performed annually in recent years, and more than 2200 patients have undergone HSCT until 2008 [16]. The present study analyzed the incidence and risk of osteoporosis and fracture in cancer patients who underwent HSCT by using Taiwan's National Health Insurance Research Database (NHIRD).…”