Formazione infermieristica EBMT: Mobilizzazione e aferesi di cellule ...
EBMT ACTIVITY SURVEY 2016. EBMT2018_Poster_Transplant... · #EBMT18 17 Activiy Survey Office...
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www.ebmt.org #EBMT18 17 Activiy Survey Office University Hospital Basel, Switzerland Helen Baldomero, Jakob Passweg EBMT ACTIVITY SURVEY 2016 Teams : 679 Participating countries: 49 Allogeneic Autologous Total 1st Allo /auto HSCT 16 507 22 806 39 313 Re/Additional transplant 1 134 3 189 4 323 Total 17 641 25995 43 636 Myeloablative HSCT 61% Main Indications 1st HSCT Myeloid malignancies 9 190 357 9 547 Lymphoid malignancies 5 037 20 581 25 618 Bone marrow failure 894 5 899 Solid tumour 33 1 483 1 516 Non-malignant dis. (excl. BMF) 1 193 367 1 560 Other Myeloid malignancies AML 1 st . CR 3 567 295 3 862 not 1 st . CR 1 780 54 1 834 AML therapy related 268 3 271 AML from MDS/MPN 666 2 668 CML 1 st . cP 173 1 174 not 1 st . cP 211 0 211 MDS or MD/MPN, MPN 2 525 2 2 527 Lymphoid neoplasia ALL 1 st . CR 1 638 80 1 718 not 1 st . CR 1 013 10 1 023 CLL 275 17 292 Plasma cell disorders 463 11 931 12 394 Hodgkin lymphoma 390 2 045 2 435 Non-Hodgkin lymphoma 1 258 6 498 7 756 Solid tumors Neuroblastoma 20 479 499 Soft tissue sarcoma/Ewing 6 190 196 Germ cell tumor 1 399 400 Breast cancer 0 21 21 Other solid tumor 6 394 400 Non malignant disorders Bone marrow failure - SAA 642 5 647 Bone marrow failure - other 252 0 252 Thalassemia 329 6 335 Sickle cell disease 137 1 138 Primary immune deficiency 550 5 555 Inherited disorder of metabolism 150 4 154 Auto immune disorder 27 351 378 Others 160 13 173 Trends • Number of HSCT continue to increase: > 43 600 HSCT • Continued increase in haplo-identical HSCT in both BM and PBSC • Notable increase in AID autologous HSCT since 2009 • Cellular therapies increased by 22% since 2015 • Slight levelling off in unrelated and cord blood HSCT Trend in donor selection Trend in cord blood HSCT Patient and Transplant Numbers Paediatric patients Family Unrelated Autologous HLA-id/twin Haplo Other family BM PB CB BM PB BM PB CB BM PB CB BM PB CB 930 256 37 122 423 100 68 2 859 541 207 58 1 086 1 1 938 1 607 1 145 Epub: JR. Passweg, H. Baldomero et al, Bone Marrow Transplantation January 2018 ([email protected]) N. patients MSC NK cells select/exp T cells or CIK Reg T cells (TREGS) Genetic mod. T cells Dendritic cells Expanded CD34+ cells Genetic mod. CD34+ cells Other Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto GvHD 421 2 4 31 1 11 36 Graft enhancement 17 4 5 20 1 14 1 75 22 AID 9 19 Genetic disease 1 1 1 Infection 4 157 7 Malignancy 1 9 32 3 28 6 29 3 45 1 8 16 1 Regenerative med. 5 8 1 14 79 Total 458 33 14 0 213 3 59 0 7 29 3 45 16 1 1 8 124 139 Non HSCT Cellular therapies using manipulated or selected cells in 2016 Myeloid Lymphoid NMD ST • Unrelated donor HSCT are done mainly in very high income countries. • Rates of haplo-identical HSCT are higher in the high income group compared to the very high income group: possible favored use over unrelated HSCT due to economical considerations? • Upper middle income groups concentrate on sibling donor HSCT, pointing towards restricting HSCT to the best possible donor in a situation of limited resources. Trend in autoimmune disease: autologous HSCT Main Indication by transplant type Allogeneic Autologous HSCT in Europe 2016 Activity Survey 2016 Leukemias, 2% PCD, 52% HL, 9% NHL, 29% Neuroblastoma, 2% Soft tissue/Ewing, 1% Germinal tumors , 2% Breast, 0,1% Other ST, 2% NMD, 0.1% AID, 2% Others , 0,1% AML, 38% CML, 2% MDS 11% MPN, 4% ALL, 16% CLL, 2% HL, 2% NHL, 8% PCD, 2,8% Solid tumors, 0,2% BMF, 5% Thal/sickle, 3% PID, 3% IDM, 0,9% AID, 0,2% Others, 1% 0 50 100 150 200 250 300 350 400 97 99 01 03 05 07 09 11 13 15 H S C T Year AID auto Transplant rates per 10 million inhabitants. Income group Very high High Upper middle Identical sibling 390 283 102 Haplo-identical 77 106 16 Unrelated 978 321 16
Transcript of EBMT ACTIVITY SURVEY 2016. EBMT2018_Poster_Transplant... · #EBMT18 17 Activiy Survey Office...
www.ebmt.org #EBMT18 17
Activiy Survey Office
University Hospital Basel, Switzerland
Helen Baldomero, Jakob Passweg
EBMT ACTIVITY SURVEY 2016
Teams : 679 Participating countries: 49
Allogeneic Autologous Total
1st Allo /auto HSCT 16 507 22 806 39 313
Re/Additional transplant 1 134 3 189 4 323
Total 17 641 25995 43 636
Myeloablative HSCT 61%
Main Indications 1st HSCT
Myeloid malignancies 9 190 357 9 547
Lymphoid malignancies 5 037 20 581 25 618
Bone marrow failure 894 5 899
Solid tumour 33 1 483 1 516
Non-malignant dis. (excl. BMF) 1 193 367 1 560
Other
Myeloid malignancies
AML 1st. CR 3 567 295 3 862
not 1st. CR 1 780 54 1 834
AML therapy related 268 3 271
AML from MDS/MPN 666 2 668
CML 1st. cP 173 1 174
not 1st. cP 211 0 211
MDS or MD/MPN, MPN 2 525 2 2 527
Lymphoid neoplasia
ALL 1st. CR 1 638 80 1 718
not 1st. CR 1 013 10 1 023
CLL 275 17 292
Plasma cell disorders 463 11 931 12 394
Hodgkin lymphoma 390 2 045 2 435
Non-Hodgkin lymphoma 1 258 6 498 7 756
Solid tumors
Neuroblastoma 20 479 499
Soft tissue sarcoma/Ewing 6 190 196
Germ cell tumor 1 399 400
Breast cancer 0 21 21
Other solid tumor 6 394 400
Non malignant disorders
Bone marrow failure - SAA 642 5 647
Bone marrow failure - other 252 0 252
Thalassemia 329 6 335
Sickle cell disease 137 1 138
Primary immune deficiency 550 5 555
Inherited disorder of metabolism 150 4 154
Auto immune disorder 27 351 378
Others 160 13 173
Trends
• Number of HSCT continue to increase: > 43 600 HSCT
• Continued increase in haplo-identical HSCT in both BM and PBSC
• Notable increase in AID autologous HSCT since 2009
• Cellular therapies increased by 22% since 2015
• Slight levelling off in unrelated and cord blood HSCT
Trend in donor selection Trend in cord blood HSCT
Patient and Transplant Numbers
Paediatric patients
Family Unrelated Autologous
HLA-id/twin Haplo Other family BM PB CB BM PB BM PB CB BM PB CB BM PB CB
930 256 37 122 423 100 68 2 859 541 207 58 1 086 1
1 938 1 607 1 145
Epub: JR. Passweg, H. Baldomero et al, Bone Marrow Transplantation January 2018 ([email protected])
N. patients MSC NK cells
select/exp
T cells or
CIK
Reg T
cells
(TREGS)
Genetic
mod. T
cells
Dendritic
cells
Expanded
CD34+
cells
Genetic
mod.
CD34+
cells
Other
Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto Allo Auto
GvHD 421 2 4 31 1 11 36
Graft
enhancement 17 4 5 20 1 14 1 75 22
AID 9 19
Genetic
disease 1 1 1
Infection 4 157 7
Malignancy 1 9 32 3 28 6 29 3 45 1 8 16 1
Regenerative
med. 5 8 1 14 79
Total 458 33 14 0 213 3 59 0 7 29 3 45 16 1 1 8 124 139
Non HSCT Cellular therapies using manipulated or selected cells in
2016
Myeloid Lymphoid NMD ST
• Unrelated donor HSCT are done mainly in very high income
countries.
• Rates of haplo-identical HSCT are higher in the high income
group compared to the very high income group: possible
favored use over unrelated HSCT due to economical
considerations?
• Upper middle income groups concentrate on sibling donor
HSCT, pointing towards restricting HSCT to the best
possible donor in a situation of limited resources.
Trend in autoimmune disease:
autologous HSCT
Main Indication by transplant type
Allogeneic Autologous
HSCT in Europe 2016 Activity Survey 2016
Leukemias, 2%
PCD, 52%
HL, 9%
NHL, 29%
Neuroblastoma, 2%
Soft tissue/Ewing,
1%
Germinal tumors , 2%
Breast, 0,1% Other ST, 2%
NMD, 0.1% AID, 2%
Others , 0,1%
AML, 38%
CML, 2%
MDS 11% MPN, 4%
ALL, 16%
CLL, 2%
HL, 2%
NHL, 8%
PCD, 2,8%
Solid tumors, 0,2%
BMF, 5%
Thal/sickle, 3%
PID, 3% IDM, 0,9%
AID, 0,2%
Others, 1%
0
50
100
150
200
250
300
350
400
97 99 01 03 05 07 09 11 13 15
H
S
C
T
Year
AID auto
Transplant rates per 10 million inhabitants.
Income group Very high High Upper middle
Identical sibling 390 283 102
Haplo-identical 77 106 16
Unrelated 978 321 16
