PDF《past 15 years》

SPECIAL REPORT EBMT activity survey

2004 and changes in disease indication over the past

15 years A Gratwohl1 , H Baldomero1 , K Frauendorfer2 and A Urbano-Ispizua3 , for the Joint Accreditation Committee of the International Society for Cellular Therapy ISCT and the European Group for Blood and Marrow Transplantation EBMT (JACIE)

1 Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland;

2 Institute for Operations Research and Computational Finance, University of St Gallen, St Gallen, Switzerland and

3 JACIE of?ce, Hospital Clinic, Barcelona, Spain This ?fteenth annual European Group for Blood and Marrow Transplantation activity report lists the trans- plant activity in Europe in

2004 and documents the changes in indication over the past

15 years.

In 2004, there were

22 216 ?rst hematopoetic stem cells (HSCT),

7407 allogeneic (33%),

14 809 autologous (67%) and

4378 additional re- or multiple transplants reported from

592 centres in

38 European and ?ve af?liated countries. Main indications were leukemias (7045 (32%;

78% allogeneic));

lymphomas (12

310 (55%;

94% autologous));

solid tumors (1759 (8%;

93% autologous)) and nonmalignant disorders (1015 (5%;

92% allogeneic)). In comparison,

145 teams from

20 countries performed

4234 HSCT (2137 allo- geneic, 50%;

2097 autologous, 50%) in 1990. The overall increase was accompanied by major changes. Stem cell source changed from bone marrow to peripheral blood. More than one-third of allogeneic HSCT are now from unrelated donors. Reduced intensity conditioning is employed for one-third of allogeneic HSCT. Leukemias for allogeneic and lymphoproliferative disorders for autologous HSCT continue to increase. The decline in HSCT for chronic myeloid leukemia appears to level off for the ?rst time since 1999. These data are informative for patient counselling and decision making for health care professionals. Bone Marrow Transplantation (2006) 37, 1069C1085. doi:10.1038/sj.bmt.1705377 Keywords: hematopoietic stem cell transplantation;

Europe;

transplant rates;

leukemia;

solid tumor;

non- malignant diseases Introduction Transplantation of hematopoietic stem cells (HSCT) offers a unique opportunity for long-term disease control to many patients with severe malignant or hematopoietic stem cells malignant, acquired or congenital disorders of the hemato- poietic system or with chemo-radiosensitive tumors.1C3 HSC has seen rapid expansion over the last decade and the increasing demand for this high-cost procedure can present a challenge for health care systems in any country. Precise information on current use and trends is essential for patients, physicians and health care providers alike.4,5 The activity survey of the European Group for Blood and Marrow Transplantation (EBMT) was designed in

1990 to provide this information in a most ef?cient way and to disseminate it rapidly on an annual basis.6 All EBMT members and af?liated teams, known to perform trans- plants, were requested to report their numbers of patients transplanted by indication, stem cell source and donor type on an annual basis. The initial survey sheet was slightly changed over the years, to respond to changes in indication and to collect additional generic information on the numbers of re- or multiple transplants, on the percentage of cord blood HSCT and on the percentage of transplants with reduced intensity conditioning (RIC HSCT). The EBMT survey was adopted by the General Assembly as a mandatory self-reporting system. It forms now an integral part of a comprehensive quality assurance program JACIE (Joint Accreditation Committee of the International Society for Cellular Therapy (ISCT) and the EBMT (http://www.EBMT.org/http://www.JACIE.org)). With a follow-up of