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Quantitative and Qualitative Differences in Use and Trends of Hematopoietic Stem Cell Transplantation : A Global Observational Study
Journal
Haematologica
ISSN
0390-6078
ISSN-Digital
1592-8721
Type
journal article
Date Issued
2013-08
Author(s)
Gratwohl, Alois
Baldomero, Helen
Gratwοhl, Μichael
Aljurf, Mahmoud
Bouzas, Luis
Horowitz, Mary
Kodera, Yoshihisa
Lipton, Jeff
Iida, Minako
Pasquini, Marcelo
Passweg, Jakob
Szer, Jeff
Madrigal, Alejandro
Niederwieser, Dietger
Abstract
After 55 years since its first publication stem cell transplantation is considered the optimal treatment option for specific hematological and non-hematological diseases. There is considerable interest in understanding differences of its use and trends at a global level. This analysis aims at analyzing differences in indications, world regions and macroeconomic factors over a three year period.
Data from 2006-2008 were obtained from WBMT member registries and from transplant centers in countries without registries, pooled and duplicate reporting removed. Population and macroeconomic data were collected from the World Bank and from the International Monetary Fund. Transplant rates were analyzed by indication, donor type, country, and World Health Organization regional offices areas and related to selected health care indicators using single and multiple linear regression analyses.
A total of 146,808 patients after stem cell transplantation were reported by 1,411 teams from 72 countries over 5 continents. Annual number of transplants (+11%) steadily increased, but preferentially in high (p=0.02) and not in low or medium income countries. Highest increase was observed in the Asia Pacific region and, among alllogeneic transplants, in myelodysplasia, chronic lymphocytic and acute leukemias, nonmalignant diseases (>+21%). Among autologous transplantation autoimmune and lymphoproliferative diseases increased. A clear negative trend was seen in allogeneic for chronic myelogenous leukemia and in autologous transplants for leukemias and solid tumors. Transplant rates (p< 0.01), donor type (p< 0.01) and disease indications (p < 0.01) differed significantly between countries and regions and were associated with Gross National Income/capita (p < 0.01) but showed a wide variation of explanatory content by donor type and disease indication.
An increase of stem cell transplant activity is observed worldwide but with significant regional differences. The preferential increase in high income country indicates a widening gap between low and high income countries.
Data from 2006-2008 were obtained from WBMT member registries and from transplant centers in countries without registries, pooled and duplicate reporting removed. Population and macroeconomic data were collected from the World Bank and from the International Monetary Fund. Transplant rates were analyzed by indication, donor type, country, and World Health Organization regional offices areas and related to selected health care indicators using single and multiple linear regression analyses.
A total of 146,808 patients after stem cell transplantation were reported by 1,411 teams from 72 countries over 5 continents. Annual number of transplants (+11%) steadily increased, but preferentially in high (p=0.02) and not in low or medium income countries. Highest increase was observed in the Asia Pacific region and, among alllogeneic transplants, in myelodysplasia, chronic lymphocytic and acute leukemias, nonmalignant diseases (>+21%). Among autologous transplantation autoimmune and lymphoproliferative diseases increased. A clear negative trend was seen in allogeneic for chronic myelogenous leukemia and in autologous transplants for leukemias and solid tumors. Transplant rates (p< 0.01), donor type (p< 0.01) and disease indications (p < 0.01) differed significantly between countries and regions and were associated with Gross National Income/capita (p < 0.01) but showed a wide variation of explanatory content by donor type and disease indication.
An increase of stem cell transplant activity is observed worldwide but with significant regional differences. The preferential increase in high income country indicates a widening gap between low and high income countries.
Language
English
Keywords
Hematopoietic stem cell transplantation
autologous
allogeneic
global perspective
transplant rates
leukemia
lym¬phoma
solid tumors
non-malignant disorders
unrelated donors
HSG Classification
contribution to scientific community
Refereed
Yes
Publisher
Ferrata Storti Foundation
Publisher place
Pavia, Italy
Volume
98
Number
8
Start page
1282
End page
1290
Pages
9
Subject(s)
Division(s)
Eprints ID
222270