Allogeneic and autologous transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe 2009

Abstract

The European Group for Blood and Marrow Transplantation regularly publishes special reports on the current practice of haematopoietic SCT for haematological diseases, solid tumours and immune disorders in Europe. Major changes have occurred since the first report was published. HSCT today includes grafting with allogeneic and autologous stem cells derived from BM, peripheral blood and cord blood. With reduced-intensity conditioning regimens in allogeneic transplantation, the age limit has increased, permitting the inclusion of older patients. New indications have emerged, such as autoimmune disorders and AL amyloidosis for autologous HSCT and solid tumours, myeloproliferative syndromes and specific subgroups of lymphomas for allogeneic transplants. The introduction of alternative therapies, such as imatinib for CML, has challenged well-established indications. An updated report with revised tables and operating definitions is presented

Impact of the source of hematopoietic stem cell in unrelated transplants: Comparison between 10/10, 9/10‐HLAmatched donors and cord blood

“…Allogeneic hematopoietic stem cell transplantation (HSCT) offers potential curative treatment for a wide range of hematological disorders [1]. In patients that lack an available matched-related or -unrelated donor (MUD), mismatched-unrelated donors (MMUD), unrelated cord blood (UCB), and haploidentical related donors have emerged as effective alternative stem cell sources.…”

The role of the endothelium in the short-term complications of hematopoietic SCT

“…1 However, HSCT is not an innocuous procedure and may be associated with several early and late life-threatening complications. Those complications that appear early after HSCT are usually caused by the toxicity of the conditioning regimen, infections or immune reactions (mainly GVHD).…”

Having a sibling as donor: Patients' experiences immediately before allogeneic hematopoietic stem cell transplantation

“…The indications for HSCT are mainly haematological malignancies, but it is also used for a variety of other disorders ( Figure 1) (Copelan, 2006;Gratwohl et al, 2010;Ljungman et al, 2010;Passweg et al, 2014). In Europe there has been a doubling in numbers between 2001 and 2011, with more than 14 000 allogeneic HSCTs performed in 2011 (Gratwohl et al, 2013;Passweg et al, 2013).…”

“…However, the five-year event-free survival rate for patients receiving a transplant from an HLA-identical sibling donor, when the disease is under reasonable control at the time of transplant, is 30-80% (Copelan, 2006). Even though the treatment offers a potential cure for a variety of diseases there is a significant risk of acute complications and late side effects, and of mortality (Copelan, 2006;Ljungman et al, 2010;Pidala et al, 2009 One essential prerequisite for performing an HSCT is finding a suitable donor, i.e. a donor who has a reasonable HLA match.…”