Gratwohl A, Passweg J, Baldomero H, Hermans J
Department of Internal Medicine, Kantonsspital Basel, Switzerland.
Bone Marrow Transplant. 1999 Aug;24(3):231-45. doi: 10.1038/sj.bmt.1701866.
Data from the annual survey on transplant activity 1997, collected from 457 transplant teams in 31 European countries by the European Group for Blood and Marrow Transplantation (EBMT) were used to describe current status and to assess relative and absolute changes in indication, donor type and stem cell source compared to 1991. A total of 16950 patients were reported to have a first blood or marrow transplant in 1997, a total of 18 923 procedures, including re- and double transplants were performed. Of the 16950 first transplants, 4751 (28%) were allogeneic, 12199 (72%) autologous transplants. Of the autologous transplants, 829 (7%) were bone marrow derived, 11370 (93%) from peripheral blood stem cells or combined bone marrow and peripheral blood stem cell transplants. Of the allogeneic transplants, 3311 (70%) were bone marrow, 1440 (30%) were peripheral blood stem cell transplants. In 1991, the respective figures were 2175 allogeneic (44%) and 2786 (56%) autologous transplants, more than 90% of the autologous, all allogeneic transplants bone marrow derived. Main indications in 1997 were leukemias with 5253 transplants (31%), 70% allogeneic; lymphomas with 6773 transplants (40%), 94% autologous; solid tumors with 4154 transplants (24%), 99% autologous; non-malignant disorders with 770 transplants (5 %), 85 % allogeneic. There was an absolute increase of 11971 transplants since 1991. An increase was observed in all disease categories. Marked differences were found, when the relative increase index (RII) for specific disease categories over time was analyzed. In allogeneic transplants, relatively more transplants were performed in 1997 for acute myeloid leukemia beyond 1st complete remission (RII 1.28), myelodysplastic syndromes (RII 1.58), chronic lymphocytic leukemia (RII 1.33) and non-Hodgkin's lymphoma (RII 1.58). For autologous transplant indications, a high relative increase index was observed in myelodysplastic syndromes (RII 3.77), in multiple myeloma (RII 2.12) and carcinoma of the breast (RII 6.37) with a relative decrease in leukemias (RII 0.39) and certain solid tumors such as glioma (RII 0.27) and neuroblastoma (RII 0.46). These data present the current status of blood and marrow transplantation in Europe. They show the change from bone marrow to blood as stem cell source and highlight shifts in indication. They provide a basis for patient counselling and health care planning.
欧洲血液和骨髓移植组（EBMT）从31个欧洲国家的457个移植团队收集的1997年年度移植活动调查数据，用于描述当前状况，并评估与1991年相比，在适应证、供体类型和干细胞来源方面的相对和绝对变化。1997年共有16950例患者接受了首次血液或骨髓移植，共进行了18923例移植手术，包括再次移植和双重移植。在16950例首次移植中，4751例（28%）为异基因移植，12199例（72%）为自体移植。在自体移植中，829例（7%）来自骨髓，11370例（93%）来自外周血干细胞或骨髓与外周血干细胞联合移植。在异基因移植中，3311例（70%）为骨髓移植，1440例（30%）为外周血干细胞移植。1991年，相应的数据分别为2175例异基因移植（44%）和2786例自体移植（56%），超过90%的自体移植和所有异基因移植均来自骨髓。1997年的主要适应证为白血病，共进行了5253例移植（31%），其中70%为异基因移植；淋巴瘤6773例移植（40%），其中94%为自体移植；实体瘤4154例移植（24%），其中99%为自体移植；非恶性疾病770例移植（5%），其中85%为异基因移植。自1991年以来，移植手术绝对增加了11971例。所有疾病类别均有增加。在分析特定疾病类别随时间的相对增加指数（RII）时，发现了显著差异。在异基因移植中，1997年进行的急性髓系白血病首次完全缓解后移植（RII 1.28）、骨髓增生异常综合征（RII 1.58）、慢性淋巴细胞白血病（RII 1.33）和非霍奇金淋巴瘤（RII 1.58）相对较多。对于自体移植适应证，骨髓增生异常综合征（RII 3.77）、多发性骨髓瘤（RII 2.12）和乳腺癌（RII 6.37）的相对增加指数较高，而白血病（RII 0.39）和某些实体瘤如神经胶质瘤（RII 0.27）和神经母细胞瘤（RII 0.46）则相对减少。这些数据展示了欧洲血液和骨髓移植的当前状况。它们显示了干细胞来源从骨髓向血液的转变，并突出了适应证的变化。它们为患者咨询和医疗保健规划提供了依据。
