TRENDS IN THE USE OF HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR ADULTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA: A REPORT FROM THE ACUTE LEUKEMIA WORKING PARTY OF EBMT
(Abstract release date: 05/19/16)
EHA Library. Giebel S. 06/11/16; 135280; S524
Dr. Sebastian Giebel
Contributions
Contributions
Abstract
Abstract: S524
Type: Oral Presentation
Presentation during EHA21: On Saturday, June 11, 2016 from 16:45 - 17:00
Location: Room H5
Background
Indications for hematopoietic stem cell transplantation (HSCT) for adults with acute lymphoblastic leukemia (ALL) evolve over time and vary among countries as well as the methodology of the procedures.
Aims
The goal of this study was to assess general trends in the number of various types of HSCTs performed between years 2001 and 2012 in Europe.
Methods
Data reported to the European Society for Blood and Marrow Transplantation (EBMT) registry were used for this analysis. In addition, we evaluated HSCT rates with respect to the incidence of ALL in selected European countries.
Results
Altogether, 11602 first allogeneic (n=9938) or autologous (n=1664) HSCTs were performed in the period 2001-2012. Comparing years 2010-2012 and 2001-2003, the number of alloHSCTs performed in first CR increased by 108%, most prominently for transplantations from unrelated (219%) and mismatched related donors (89%). The number of HSCTs from matched sibling donors increased by 43%, while the number of autoHSCTs decreased by 71% (Table). The increase of the use of alloHSCT, irrespective of the disease stage, was stronger for Ph-pos (108%) than Ph-neg ALL (21%) while similar for B- and T-ALL. Among patients aged >55 years, the number of alloHSCT increased by 386% while among younger adults (18-55 years), by 48%. Between 2001 and 2003, peripheral blood was used as source of stem cells in 69% cases of alloHSCT, compared to 93% between 2010-2012 (p<0.0001). The use of bone marrow decreased from 30% to 6%, respectively (p<0.0001). The proportion of alloHSCT with reduced-intensity conditioning (RIC) increased from 6% to 19% (p<0.0001). Among myeloablative transplantations, regimens based on total body irradiation were the preferable option (app. 80% over the whole study period, p=NS). In contrast, among RIC regimens, the use of chemotherapy predominated (75% between 2010-2012, p=0.006). In most of analyzed individual countries, the estimated rates of alloHSCT (no. HSCT per 100 newly diagnosed ALL) for patients in CR1 increased over time. However, the values for a period 2010-2012 varied strongly, being highest in the Netherlands (42.2), followed by the UK (32.3) and France (32.2) while lowest in Russia (0.8). HSCT rates correlated with socio-economic status of a country as defined by the Human Development Index (R=0.71, p=0.046).
Conclusion
Results of our analysis indicate a continuous trend for an increased use of alloHSCT for adults with ALL, which may be attributed to increasing availability of unrelated donors. However, it may also be speculated that the introduction of tyrosine kinase inhibitors allowed higher proportion of patients with Ph-pos ALL proceeding to transplantation. Finally, the implementation of RIC regimens contributed to wider use of alloHSCT among older adults. Limitations of the analysis include any assumptions made regarding ALL incidence for the specified time period and possible variation in reporting to the EBMT registry from different countries over time.
Session topic: Stem cell transplantation - Clinical 1
Keyword(s): Acute lymphoblastic leukemia, Allogeneic hematopoietic stem cell transplant, Autologous hematopoietic stem cell transplantation, Incidence
Type: Oral Presentation
Presentation during EHA21: On Saturday, June 11, 2016 from 16:45 - 17:00
Location: Room H5
Background
Indications for hematopoietic stem cell transplantation (HSCT) for adults with acute lymphoblastic leukemia (ALL) evolve over time and vary among countries as well as the methodology of the procedures.
Aims
The goal of this study was to assess general trends in the number of various types of HSCTs performed between years 2001 and 2012 in Europe.
Methods
Data reported to the European Society for Blood and Marrow Transplantation (EBMT) registry were used for this analysis. In addition, we evaluated HSCT rates with respect to the incidence of ALL in selected European countries.
Results
Altogether, 11602 first allogeneic (n=9938) or autologous (n=1664) HSCTs were performed in the period 2001-2012. Comparing years 2010-2012 and 2001-2003, the number of alloHSCTs performed in first CR increased by 108%, most prominently for transplantations from unrelated (219%) and mismatched related donors (89%). The number of HSCTs from matched sibling donors increased by 43%, while the number of autoHSCTs decreased by 71% (Table). The increase of the use of alloHSCT, irrespective of the disease stage, was stronger for Ph-pos (108%) than Ph-neg ALL (21%) while similar for B- and T-ALL. Among patients aged >55 years, the number of alloHSCT increased by 386% while among younger adults (18-55 years), by 48%. Between 2001 and 2003, peripheral blood was used as source of stem cells in 69% cases of alloHSCT, compared to 93% between 2010-2012 (p<0.0001). The use of bone marrow decreased from 30% to 6%, respectively (p<0.0001). The proportion of alloHSCT with reduced-intensity conditioning (RIC) increased from 6% to 19% (p<0.0001). Among myeloablative transplantations, regimens based on total body irradiation were the preferable option (app. 80% over the whole study period, p=NS). In contrast, among RIC regimens, the use of chemotherapy predominated (75% between 2010-2012, p=0.006). In most of analyzed individual countries, the estimated rates of alloHSCT (no. HSCT per 100 newly diagnosed ALL) for patients in CR1 increased over time. However, the values for a period 2010-2012 varied strongly, being highest in the Netherlands (42.2), followed by the UK (32.3) and France (32.2) while lowest in Russia (0.8). HSCT rates correlated with socio-economic status of a country as defined by the Human Development Index (R=0.71, p=0.046).
Conclusion
Results of our analysis indicate a continuous trend for an increased use of alloHSCT for adults with ALL, which may be attributed to increasing availability of unrelated donors. However, it may also be speculated that the introduction of tyrosine kinase inhibitors allowed higher proportion of patients with Ph-pos ALL proceeding to transplantation. Finally, the implementation of RIC regimens contributed to wider use of alloHSCT among older adults. Limitations of the analysis include any assumptions made regarding ALL incidence for the specified time period and possible variation in reporting to the EBMT registry from different countries over time.
Session topic: Stem cell transplantation - Clinical 1
Keyword(s): Acute lymphoblastic leukemia, Allogeneic hematopoietic stem cell transplant, Autologous hematopoietic stem cell transplantation, Incidence
Abstract: S524
Type: Oral Presentation
Presentation during EHA21: On Saturday, June 11, 2016 from 16:45 - 17:00
Location: Room H5
Background
Indications for hematopoietic stem cell transplantation (HSCT) for adults with acute lymphoblastic leukemia (ALL) evolve over time and vary among countries as well as the methodology of the procedures.
Aims
The goal of this study was to assess general trends in the number of various types of HSCTs performed between years 2001 and 2012 in Europe.
Methods
Data reported to the European Society for Blood and Marrow Transplantation (EBMT) registry were used for this analysis. In addition, we evaluated HSCT rates with respect to the incidence of ALL in selected European countries.
Results
Altogether, 11602 first allogeneic (n=9938) or autologous (n=1664) HSCTs were performed in the period 2001-2012. Comparing years 2010-2012 and 2001-2003, the number of alloHSCTs performed in first CR increased by 108%, most prominently for transplantations from unrelated (219%) and mismatched related donors (89%). The number of HSCTs from matched sibling donors increased by 43%, while the number of autoHSCTs decreased by 71% (Table). The increase of the use of alloHSCT, irrespective of the disease stage, was stronger for Ph-pos (108%) than Ph-neg ALL (21%) while similar for B- and T-ALL. Among patients aged >55 years, the number of alloHSCT increased by 386% while among younger adults (18-55 years), by 48%. Between 2001 and 2003, peripheral blood was used as source of stem cells in 69% cases of alloHSCT, compared to 93% between 2010-2012 (p<0.0001). The use of bone marrow decreased from 30% to 6%, respectively (p<0.0001). The proportion of alloHSCT with reduced-intensity conditioning (RIC) increased from 6% to 19% (p<0.0001). Among myeloablative transplantations, regimens based on total body irradiation were the preferable option (app. 80% over the whole study period, p=NS). In contrast, among RIC regimens, the use of chemotherapy predominated (75% between 2010-2012, p=0.006). In most of analyzed individual countries, the estimated rates of alloHSCT (no. HSCT per 100 newly diagnosed ALL) for patients in CR1 increased over time. However, the values for a period 2010-2012 varied strongly, being highest in the Netherlands (42.2), followed by the UK (32.3) and France (32.2) while lowest in Russia (0.8). HSCT rates correlated with socio-economic status of a country as defined by the Human Development Index (R=0.71, p=0.046).
Conclusion
Results of our analysis indicate a continuous trend for an increased use of alloHSCT for adults with ALL, which may be attributed to increasing availability of unrelated donors. However, it may also be speculated that the introduction of tyrosine kinase inhibitors allowed higher proportion of patients with Ph-pos ALL proceeding to transplantation. Finally, the implementation of RIC regimens contributed to wider use of alloHSCT among older adults. Limitations of the analysis include any assumptions made regarding ALL incidence for the specified time period and possible variation in reporting to the EBMT registry from different countries over time.
Session topic: Stem cell transplantation - Clinical 1
Keyword(s): Acute lymphoblastic leukemia, Allogeneic hematopoietic stem cell transplant, Autologous hematopoietic stem cell transplantation, Incidence
Type: Oral Presentation
Presentation during EHA21: On Saturday, June 11, 2016 from 16:45 - 17:00
Location: Room H5
Background
Indications for hematopoietic stem cell transplantation (HSCT) for adults with acute lymphoblastic leukemia (ALL) evolve over time and vary among countries as well as the methodology of the procedures.
Aims
The goal of this study was to assess general trends in the number of various types of HSCTs performed between years 2001 and 2012 in Europe.
Methods
Data reported to the European Society for Blood and Marrow Transplantation (EBMT) registry were used for this analysis. In addition, we evaluated HSCT rates with respect to the incidence of ALL in selected European countries.
Results
Altogether, 11602 first allogeneic (n=9938) or autologous (n=1664) HSCTs were performed in the period 2001-2012. Comparing years 2010-2012 and 2001-2003, the number of alloHSCTs performed in first CR increased by 108%, most prominently for transplantations from unrelated (219%) and mismatched related donors (89%). The number of HSCTs from matched sibling donors increased by 43%, while the number of autoHSCTs decreased by 71% (Table). The increase of the use of alloHSCT, irrespective of the disease stage, was stronger for Ph-pos (108%) than Ph-neg ALL (21%) while similar for B- and T-ALL. Among patients aged >55 years, the number of alloHSCT increased by 386% while among younger adults (18-55 years), by 48%. Between 2001 and 2003, peripheral blood was used as source of stem cells in 69% cases of alloHSCT, compared to 93% between 2010-2012 (p<0.0001). The use of bone marrow decreased from 30% to 6%, respectively (p<0.0001). The proportion of alloHSCT with reduced-intensity conditioning (RIC) increased from 6% to 19% (p<0.0001). Among myeloablative transplantations, regimens based on total body irradiation were the preferable option (app. 80% over the whole study period, p=NS). In contrast, among RIC regimens, the use of chemotherapy predominated (75% between 2010-2012, p=0.006). In most of analyzed individual countries, the estimated rates of alloHSCT (no. HSCT per 100 newly diagnosed ALL) for patients in CR1 increased over time. However, the values for a period 2010-2012 varied strongly, being highest in the Netherlands (42.2), followed by the UK (32.3) and France (32.2) while lowest in Russia (0.8). HSCT rates correlated with socio-economic status of a country as defined by the Human Development Index (R=0.71, p=0.046).
Conclusion
Results of our analysis indicate a continuous trend for an increased use of alloHSCT for adults with ALL, which may be attributed to increasing availability of unrelated donors. However, it may also be speculated that the introduction of tyrosine kinase inhibitors allowed higher proportion of patients with Ph-pos ALL proceeding to transplantation. Finally, the implementation of RIC regimens contributed to wider use of alloHSCT among older adults. Limitations of the analysis include any assumptions made regarding ALL incidence for the specified time period and possible variation in reporting to the EBMT registry from different countries over time.
Session topic: Stem cell transplantation - Clinical 1
Keyword(s): Acute lymphoblastic leukemia, Allogeneic hematopoietic stem cell transplant, Autologous hematopoietic stem cell transplantation, Incidence
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