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造血细胞移植治疗血液系统疾病、实体瘤和免疫性疾病的适应证:2022 年欧洲的现行实践。

Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022.

机构信息

Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

EBMT Executive Office, Barcelona, Spain.

出版信息

Bone Marrow Transplant. 2022 Aug;57(8):1217-1239. doi: 10.1038/s41409-022-01691-w. Epub 2022 May 19.

Abstract

For over two decades, the EBMT has updated recommendations on indications for haematopoietic cell transplantation (HCT) practice based on clinical and scientific developments in the field. This is the eighth special EBMT report on the indications for HCT for haematological diseases, solid tumours and immune disorders. Our aim is to provide general guidance on HCT indications according to prevailing clinical practice in EBMT countries and centres. In order to inform patient decisions, these recommendations must be considered in conjunction with the risk of the disease, risk of HCT procedure and non-transplant strategies, including evolving cellular therapies. HCT techniques are constantly evolving and we make no specific recommendations, but encourage harmonisation of practice, where possible, to ensure experience across indications can be meaningfully aggregated via registry outputs. We also recommend working according to JACIE accreditation standards to maintain quality in clinical and laboratory components of practice, including benchmarking of survival outcomes. Since the last edition, the COVID-19 pandemic has affected clinical decision making and activity across indications. Although the full impact of the pandemic is yet to be determined, we recommend that decision making across indications is delivered with ongoing reference to EBMT and national COVID-19 guidance, in accordance with current local conditions.

摘要

二十多年来,EBMT 根据该领域的临床和科学发展,更新了关于造血细胞移植(HCT)适应证的建议。这是第八份关于血液系统疾病、实体瘤和免疫性疾病的 HCT 适应证的特殊 EBMT 报告。我们的目标是根据 EBMT 国家和中心的现行临床实践,为 HCT 适应证提供一般指导。为了告知患者的决策,这些建议必须与疾病的风险、HCT 程序和非移植策略(包括不断发展的细胞疗法)的风险一起考虑。HCT 技术在不断发展,我们没有提出具体建议,但鼓励在可能的情况下协调实践,以确保通过注册中心的输出,对不同适应证的经验进行有意义的汇总。我们还建议按照 JACIE 认证标准开展工作,以维持临床和实验室实践各个环节的质量,包括生存结果的基准测试。自上一版以来,COVID-19 大流行影响了所有适应证的临床决策和活动。尽管 COVID-19 大流行的全部影响尚未确定,但我们建议在所有适应证的决策中,根据当前的当地情况,持续参考 EBMT 和国家 COVID-19 指南。

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