Page 42 - Haematologica May 2022

D. Niederwieser et al.
Table 2. Trend of global hematopoietic cell transplantation activity according to disease indication and donor type.
Related Related Related total Unrelated
identical non-identical
2007 2016 Δ%(07-16) 2007 2016 Δ%(07-16) 2007 2016 Δ%(07-16) 2007 2016 Δ%(07-16)
Leukemias
AML
ALL
CML MDS/MD/MPN CLL
Other leukemias
LPD
Plasma cell disorders Multiple myelomas Others
Lymphoma
Hodgkin disease Non-Hodgkin lymphoma
Solid tumors Non-malignant disorders
Bone marrow failure Severe aplastic anemia Other
Hemoglobinopathies
Immune deficiencies
Inherited diseases of metabolism Autoimmune disorders
Other non malignant disorders
Other TOTAL
8,018 14,992
87.0 100.9 96.0 -5.9 104.1 -26.2 143.2 7.8 -46.5 -21.6 200.0 29.3 69.8 48.8 -44.1 119.56 105.9 117.6 55.6 168.0 110.7 76.2 46.2 121.1 49.3 77.4
7,868 13,727 74.5
6,858 8,906 29.9 3,249 4,453 37.1 1,635 2,256 38.0
601 388 -35.4 1,044 1,559 49.3 279 166 -40.5 50 84 68.0 1,677 1,238 -26.2
542 234 -56.8 341 211 -38.1 9 23 155.6 1,135 979 -13.7 186 205 10.2 796 774 -2.8 47 4 -91.5
1,354 2,185 61.4 789 1,136 44.0 644 964 49.7 145 172 18.6 338 711 110.4 140 234 67.1 44 54 22.7
12 10 -16.7 31 40 29.0 61 66 8.2
9,997 12,399 24.0
1,101 6,056 472 3,064 376 1,702 56 236 156 905
17 53 24 96 163 758 23 64 8 54 1 10 140 681 29 170 63 511 32 42
196 1,232 65 633 48 553 17 80 21 251 84 238 19 57 1 9
6 44 12 43 1,504 8,131
450.1
549.2
352.7
321.4
480.1
211.8
300.0
365.0
178.3
575.0
900.0
386.4
486.2
711.1
31.3
528.57
873.9
1,052.1
370.6
1,095.2
183.3
200.0 63
800.0 13
633.3 38
258.3 73
440.6 11,611 20,594
3,749 2,023 663 1,211 298 74 1,877 583 356 11 1,294 222 871 84 1,559 862 700 162 359 224
7,531 3,965 624 2,472 220 180 2,023 312 279 33 1,673 377 1,296 47 3,423 1,775 1,523 252 962 472 111 19 84 109
3,610 2,015 479 1,358 316 90 1,338 245 192 7 1,093 175 683 35 984 448 320 128 66 255 98 8 109 68
6,803 88.5 2,930 45.4 484 1.0 3,144 131.5
240 -24.1
126 40.0 1,949 45.7 348 42.0 316 64.6
32 357.1 1,573 43.9 181 3.4
1,392 103.8 37 5.7
2,004
909 102.9 743 132.2 166 29.7 301 356.1 500 96.1 182 85.7
22 175.0 90 -17.4 114 67.7
103.66
10,293 17,831 73.2
unrelated and 6.7% of all allogeneic HCT). Of the 38,425 allogeneic HCT, 7,868 (20%) were bone marrow (BM)- derived, 27,963 (73%) were from PB and 2,594 (7%) from cord blood (CB). Of the 44,293 autologous HCT, 99.7% were from PB, 0.3% from BM and only three single HCT were from CB.
Discussion
The analysis of global HCT activity based on data from 2006-2016 on 700.000 HCT over the last 10 years gathered by the WBMT gives important insights into the global trends in the field of HCT.
As per previous reports,8–13 HCT activities continue to increase worldwide without plateau and exceeded 80,000 procedures annually for the first time in 2016 and are expect- ed to exceed 90,000 in 2018 to reach a total of 1.5 million by 2019. Although allogeneic HCT has increased more than autologous in recent years, the later remains the predomi- nant transplant type and LPD the leading disease indication. Leukemia is the second most frequent HCT indication and 94.9% of these use allogeneic donors. While HCT on patients with acute leukemias (predominantly in CR1, but not in non-CR1) and MDS/MPN increase, a decrease of fre- quencies in chronic leukemias (CLL and CML) was observed. Non-malignant disorders now account for 7.3%
of all HCT (89.2% of which are allogeneic) with BM failures as the most frequent group of disease indications (47.5%, mostly severe aplastic anemia). Hemoglobinopathies were the second most frequent indication (22.4%) with an increase of 222.3%. Finally, solid tumors were the indication in 3.6% of all HCT and were almost exclusively transplant- ed with autologous grafts (97%). Striking is the pronounced increase in haploidentical HCT in hemoglobinopathies, severe aplastic anemia, leukemia and LPD (especially MM and NHL) in developing countries. Findings are partly in agreement on a larger scale with the development in Europe and US, but also diverge especially on the use of haploiden- tical HCT for non-malignant diseases, in the use of autolo- gous HCT in autoimmune disease (LABMT) and in leukemias (SEAR/WPR) and in the use of allogeneic HCT in autoimmune diseases in SEAR/WPR.
There was substantial divergence in the rate of growth of HCT between different regions, with increases of more than 129% in SEAR/WPR and Latin-America over the last decade contributing strongly to the continuous global upward trend in activity. Both regions reported their major increases in non-malignant disorders, in the SEAR/WPR with allogeneic and in Latin America with autologous HCT. AFR/EMR had a remarkable growth of 80% in comparison to 65% in North America and 54% in Europe. Despite the differential increase,TRstillvarybymorethan10-foldfromregionto region. A deeper analysis of the number of HCT teams in
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