Gratwohl A, Hermans J, Baldomero H
Department of Internal Medicine, Kantonsspital Basel, Switzerland.
Bone Marrow Transplant. 1997 Mar;19(5):407-19. doi: 10.1038/sj.bmt.1700694.
In 1995, a total of 12,101 blood or marrow transplants, performed in Europe by 343 teams from 31 countries, were reported to the European Group for Blood and Marrow Transplantation (EBMT). Of these, 3858 (32%) were allogeneic, 8243 (68%) autologous transplants. Of the autologous transplants 1384 (17%) were bone marrow derived, 6504 (79%) from peripheral blood stem cells and 355 (4%) combined bone marrow and peripheral blood stem cell transplants. Of the allogeneic transplants, 571 (15%) were peripheral blood stem cell transplants, the remainder, 3287 (85%) bone marrow transplants. Main indications were leukemias with 4408 transplants (36%), 2977 allogeneic (68%) and 1431 autologous (32%); lymphomas with 4671 transplants (39%), 272 allogeneic (6%) and 4399 autologous (94%); severe aplastic anemia with 237 transplants (2%), 237 allogeneic (100%) and 0 autologous (0%); solid tumors with 2399 transplants (20%), 17 allogeneic (1%) and 2382 autologous (99%); and congenital disorders with 294 transplants (2%), 294 allogeneic (100%) and 0 autologous (0%) and others with 92 transplants (1%), 61 allogeneic (66%) and 31 autologous (34%). There were major differences between participating countries. The absolute numbers of teams and transplants per country differ widely and range from 0.2 to 33.3 teams per 10 million inhabitants (median 5.8); 3.2 to 733.3 total transplants per 10 million (median 200); 0.7 to 210 allogeneic transplants per 10 million (median 65); 0.3 to 700 autologous transplants per 10 million (median 122); 0 to 47.7 unrelated transplants per 10 million inhabitants (median 8.7). There is also a difference in the relative number of transplants for the individual indications. The coefficient of variation for selected diseases was calculated for those 14 countries with a minimum of 100 transplants. A narrow coefficient of variation indicates consensus amongst grafting physicians. It is narrowest for chronic myeloid leukemia in allogeneic transplants (36.7%) and for Hodgkin's disease in autologous transplants (44.8%). These data reflect the present status of blood and marrow transplantation in Europe and provide a basis for patient counselling and health care planning.
1995年，欧洲血液与骨髓移植组（EBMT）收到了来自31个国家343个团队在欧洲进行的总计12101例血液或骨髓移植报告。其中，3858例（32%）为同种异体移植，8243例（68%）为自体移植。在自体移植中，1384例（17%）来源于骨髓，6504例（79%）来源于外周血干细胞，355例（4%）为骨髓与外周血干细胞联合移植。在同种异体移植中，571例（15%）为外周血干细胞移植，其余3287例（85%）为骨髓移植。主要适应证为白血病，共进行了4408例移植（36%），其中2977例为同种异体移植（68%），1431例为自体移植（32%）；淋巴瘤4671例移植（39%），其中272例为同种异体移植（6%），4399例为自体移植（94%）；重型再生障碍性贫血237例移植（2%），均为同种异体移植（100%），自体移植为0例（0%）；实体瘤2399例移植（20%），其中17例为同种异体移植（1%），2382例为自体移植（99%）；先天性疾病294例移植（2%），均为同种异体移植（100%），自体移植为0例（0%）；其他疾病92例移植（1%），其中61例为同种异体移植（66%），31例为自体移植（34%）。参与国家之间存在重大差异。各国的团队数量和移植总数差异很大，每1000万居民中团队数量从0.2个到33.3个不等（中位数为5.8个）；每1000万居民中移植总数从3.2例到733.3例不等（中位数为200例）；每1000万居民中同种异体移植数量从0.7例到210例不等（中位数为65例）；每1000万居民中自体移植数量从0.3例到700例不等（中位数为122例）；每1000万居民中无关供者移植数量从0例到47.7例不等（中位数为8.7例）。各适应证移植的相对数量也存在差异。对至少进行了100例移植的14个国家，计算了选定疾病的变异系数。变异系数窄表明移植医生之间意见一致。在同种异体移植中，慢性髓细胞白血病的变异系数最窄（36.7%）；在自体移植中，霍奇金病的变异系数最窄（44.8%）。这些数据反映了欧洲血液和骨髓移植的现状，并为患者咨询和医疗保健规划提供了依据。
