Hematopoietic cell transplantation (HCT) activity in China was surveyed to assess its current status. A record number of HCTs (21 884: 16 631 allogeneic (76%) and 5253 autologous (24%)) were reported by 76 centers in China between 1 January 2008 and 30 June 2016. HCT trends included continued growth in transplant activity, a continued rapid increase in haploidentical donors (HID), and slower growth for unrelated donors, matched-related donors (MRD) and cord blood transplantation (CBT). The proportion of HID HCT among allogeneic HCTs increased from 29.6% (313/1062) in 2008 to 48.8% (1939/3975) in 2015, even 51.7% (1157/2237) in the first half of 2016. During this time frame, the proportion of MRD HCTs among allogeneic HCTs decreased from 48.1% (511/1062) to 33.0% (332/3975). The proportion of unrelated donor HCTs among allogeneic HCTs decreased from 20.4 (216/1062) to 13.6% (540/3975). The proportion of CBTs among allogeneic HCTs was increased from 2.1% (22/1062) to 4.2% (184/3975). HCTs have been increasing continuously for all indications except chronic myelogenous leukemia. Severe aplastic anemia is a common HCT indication among non-malignant diseases in China. The number of cases of allogeneic HCT for this disorder has increased annually, from 59 (5.6%) in 2008 to 569 (14.3%) in 2015, even 334 (14.9%) in the first half year in 2016. This survey clearly shows recent trends for HCTs in China.

Application of auto-SCT in the post-remission therapy for adolescents and young adults (AYAs) with ALL is controversial. We analyzed the outcomes of 79 AYAs (15 --24 years) with ALL who received our designed total therapy protocol with auto-SCT in first CR from 1990 to 2009. The estimated OS and EFS at 5 years for the cohort were 62.8±5.9 and 61.5±5.7%. The cumulative non-relapse mortality and relapse rate at 5 years for the cohort were 7.2 ± 3.1 and 33.6 ± 5.8%. Time to CR 44 weeks was the only independent unfavorable factor associated with OS, EFS and relapse in multivariate analysis. Patients in standard risk (SR) group and high risk (HR) group had better OS (78.3±7.4, 63.8±10.2 vs 38.1±11.6%) and EFS (78.0±7.4, 63.4±9.4 vs 32.4±11.3%), and lower relapse rate (15.9±6.5, 31.5±9.5 vs 65.7±11.8%) compared with patients in very high risk (VHR) group. Our data confirmed that auto-SCT-based total therapy might be an optional treatment strategy for AYAs with ALL in SR. Patients in HR also could get benefit from such schedule. But for those in VHR, allogenetic SCT is still the prior recommendation for the frequent recurrence after auto-SCT.