Results of the EBMT activity survey 2005 on haematopoietic stem cell transplantation: focus on increasing use of unrelated donors

Abstract

This EBMT activity report documents the haematopoietic stem cell transplantation (HSCT) activity in Europe in 2005. It provides numbers of HSCT by indication, donor type and stem cell source, lists the new practice of planned double transplants with allogeneic after autologous HSCT and concentrates on the increasing role of unrelated transplants over the last years. In 2005, there were 24 168 first HSCT, 8890 allogeneic (37%), 15 278 autologous (63%) and 3773 additional re-or multiple transplants reported from 597 centres in 43 participating countries. Main indications were leukaemias (7404 (31%; 82% allogeneic)); lymphomas (13 825 (57%; 89% autologous)); solid tumours (1655 (7%; 92% autologous)) and non-malignant disorders (1131 (5%; 93% allogeneic)). A total of 671 planned allogeneic after autologous HSCT were reported; the majority for myeloma (52%), lymphoma (28%) and acute myeloid leukaemia (11%). Compared to 2004, there was a 20% increase in allogeneic HSCT; numbers of autologous HSCT remained constant. The most noticeable increase was in unrelated HSCT, which comprise 41% of all allogeneic HSCT. Unrelated HSCT were preferentially performed for leukaemias and in countries with high income according to World Bank criteria. These data illustrate the current experience in Europe and form the basis for patient counselling and decisions making at health care institutions.

The changing scene of allogeneic stem cell transplantation for chronic myeloid leukemia—a report from the German Registry covering the period from 1998 to 2004

“…First, within this period, annual transplantations showed a decrease from 357 to 98, which meant a reduction to 28%. This was comparable to an EBMT study which documented a decrease from~1,400 to~800 annual SCTs for CML in chronic phase in the period 1999-2003 [3], and a CIBMTR study showed a reduction from 617 annual SCTs in 1998 to 223 in 2003 [4,20]. Likewise, to the results of previous analyses, the reduction of annual SCTs was most significant in first chronic phase to 20% of the initial transplantation rate, whereas the decrease in advanced phases was less significant (45% of the initial transplantation rate).…”

“…The CIBMTR documented as well an increase of SCTs for Table 3 Overall survival (OS) of patients with CML, multivariate analysis CP1 1 chronic phase; SCT allogeneic stem cell transplantation; CI confidence interval patients in 2. CP and AP from 24% to 41% [4], and the above EBMT study showed a greater decrease for allo-SCT in first chronic phase than in advanced disease [3]. These results suggest that allo-SCT still remains an important salvage option for patients in advanced CML.…”

“…After the introduction of the tyrosine kinase inhibitor (TKI) imatinib (IM) with estimated survival rates close to 90% after 5 years [1] and progressionfree survival of >97% once major molecular remission is achieved [2], the annual transplantation rates in CML are worldwide decreasing [3,4], especially since 2002, when IM was approved [5]. Treatment options are further broadened by second-generation TKIs such as nilotinib or dasatinib [6].…”

Criteria for initiation and evaluation of minority donor programs and application to the example of donors of Turkish descent in Germany

“…However, the overall allogeneic transplantation figures and the ratio of unrelated transplants are low compared with many other countries participating in the EBMT activity survey. 21 The results of this survey indicate the considerable influence of economic factors on transplantation figures, especially on the figures for unrelated transplantations. It therefore seems plausible that the low unrelated transplantation figures in Turkey might also be induced by economic factors and not only by a lack of matching unrelated donors.…”

Quality control and assurance in hematopoietic stem cell transplantation data registries in Japan and other countries

“…The EBMT structures Working Parties to perform registry Vietnam studies, and study procedures are also explained on the web site. The EBMT issues annual reports of transplant activities focused on different aspects of transplantation, such as general trends, alternative donor transplants, or transplants for pediatric recipients [25][26][27][28][29].…”