Indications for allo- and auto-SCT for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2015

Abstract

This is the sixth special report that the European Society for Blood and Marrow Transplantation regularly publishes on the current practice and indications for haematopoietic SCT for haematological diseases, solid tumours and immune disorders in Europe. Major changes have occurred in the field of haematopoietic SCT over the last years. Cord blood units as well as haploidentical donors have been increasingly used as stem cell sources for allo-SCT, thus, augmenting the possibility of finding a suitable donor for a patient. Continuous refinement of conditioning strategies has also expanded not only the number of potential indications but also has permitted consideration of older patients or those with co-morbidity for a transplant. There is accumulating evidence of the role of haematopoietic SCT in non-haematological disorders such as autoimmune diseases. On the other hand, the advent of new drugs and very effective targeted therapy has challenged the role of SCT in some instances or at least, modified its position in the treatment armamentarium of a given patient. An updated report with revised tables and operating definitions is presented.

HSCT: How Does It Work?

“…• The stage of the disease • The age of the patients • The lapse of time from diagnosis to transplant • The histocompatibility between donor and recipient • The donor/recipient sex combination (the overall survival decreases for male recipients having a female donor) (Sureda et al 2015a All these factors contribute to improvements in disease control and overall survival (Maziarz 2015).…”

“…Auto-HSCT is clearly indicated for patients with multiple myeloma (MM) who respond to first-line treatment, but age and general health should be considered; in MM all-HSCT has a curative potential, but the risk of mortality needs to be considered; autologous is also a standard of care for follicular lymphoma in first or subsequent relapse, while the auto-HSCT consolidation is considered a standard part of first-line treatment of younger(<60-65 yrs) patients with mantle cell lymphoma and for peripheral T-cell lymphomas and represent a reasonable treatment option. Patients with amyloidosis and without severe heart failure benefit from high dose- therapy and auto-HSCT, while allo-HSCT should be considered in relapsed younger patients after at least one new drug such as lenalidomide or bortezomib (Sureda et al 2015a). HSCT in solid tumours needs further prospective trials (Sureda et al 2015a).…”

“…Practices in infection control such as type of isolation, dietary restrictions and antimicrobial prophylaxis vary widely among transplantation centres. Nurses are pivotal in implementing practices to prevent and manage infections and associated effects following HSCT (Sureda et al 2015a). …”

“…Well-matched donors must be considered as the primary cell source (Sureda et al 2015a;Majhail et al 2015;Rowley 2013). …”

Lessons learnt from a process evaluation of an exercise intervention in patients treated with autologous stem cell transplantation

“…High‐dose chemotherapy followed by autologous stem cell transplantation (auto‐SCT) is currently the preferred treatment for patients with multiple myeloma in first line and aggressive lymphoma in first or second line (Sureda et al., 2015). Although auto‐SCT improves survival of these malignancies (Copelan, 2006), a substantial part of SCT survivors may experience deficits in their quality of life (Mosher, Redd, Rini, Burkhalter, & Duhamel, 2009; Pidala, Anasetti, & Jim, 2010).…”