Passweg J R, Baldomero H, Bader P, Bonini C, Duarte R F, Dufour C, Gennery A, Kröger N, Kuball J, Lanza F, Montoto S, Nagler A, Snowden J A, Styczynski J, Mohty M
EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland.
Klinik für Kinder- und Jugendmedizin, Klinikum der Johann-Wolfgang, Goethe-Universität, Frankfurt am Main, Germany.
Bone Marrow Transplant. 2017 Jun;52(6):811-817. doi: 10.1038/bmt.2017.34. Epub 2017 Mar 13.
Hematopoietic stem cell transplantation (HSCT) is an established procedure for many acquired and congenital disorders of the hematopoietic system. A record number of 42 171 HSCT in 37 626 patients (16 030 allogeneic (43%), 21 596 autologous (57%)) were reported by 655 centers in 48 countries in 2015. Trends include continued growth in transplant activity over the last decade, with the highest percentage increase seen in middle-income countries but the highest absolute growth in the very-high-income countries in Europe. Main indications for HSCT were myeloid malignancies 9413 (25%; 96% allogeneic), lymphoid malignancies 24 304 (67%; 20% allogeneic), solid tumors 1516 (4%; 3% allogeneic) and non-malignant disorders 2208 (6%; 90% allogeneic). Remarkable is the decreasing use of allogeneic HSCT for CLL from 504 patients in 2011 to 255 in 2015, most likely to be due to new drugs. Use of haploidentical donors for allogeneic HSCT continues to grow: 2012 in 2015, a 291% increase since 2005. Growth is seen for all diseases. In AML, haploidentical HSCT increases similarly for patients with advanced disease and for those in CR1. Both marrow and peripheral blood are used as the stem cell source for haploidentical HSCT with higher numbers reported for the latter.
造血干细胞移植(HSCT)是治疗许多获得性和先天性造血系统疾病的既定方法。2015年,48个国家的655个中心报告了37626例患者中创纪录的42171例HSCT(16030例同种异体移植(43%),21596例自体移植(57%))。趋势包括过去十年移植活动持续增长,中等收入国家增长百分比最高,但欧洲高收入国家绝对增长最高。HSCT的主要适应症为髓系恶性肿瘤9413例(25%;96%为同种异体移植)、淋巴系恶性肿瘤24304例(67%;20%为同种异体移植)、实体瘤1516例(4%;3%为同种异体移植)和非恶性疾病2208例(6%;90%为同种异体移植)。值得注意的是,用于慢性淋巴细胞白血病(CLL)的同种异体HSCT使用量从2011年的504例患者减少到2015年的255例,最可能的原因是新药。用于同种异体HSCT的单倍体相合供体使用量持续增长:2015年为2012例,自2005年以来增长了291%。所有疾病均有增长。在急性髓系白血病(AML)中,晚期疾病患者和处于完全缓解期1(CR1)的患者单倍体相合HSCT的使用量均有类似增加。骨髓和外周血均用作单倍体相合HSCT的干细胞来源,后者报告的数量更多。