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Quantitative and qualitative differences in use and trends of hematopoietic stem cell transplantation: a global observational study

Gratwohl, Alois and Baldomero, Helen and Gratwohl, Michael and Aljurf, Mahmoud and Bouzas, Luis Fernando and Horowitz, Mary and Kodera, Yoshihisa and Lipton, Jeff and Iida, Minako and Pasquini, Marcelo C. and Passweg, Jakob and Szer, Jeff and Madrigal, Alejandro and Frauendorfer, Karl and Niederwieser, Dietger and Worldwide Network of Blood, and Marrow Transplantation, . (2013) Quantitative and qualitative differences in use and trends of hematopoietic stem cell transplantation: a global observational study. Haematologica, 98 (8). pp. 1282-1290.

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Abstract

Fifty-five years after publication of the first hematopoietic stem cell transplantation this technique has become an accepted treatment option for defined hematologic and non-hematologic disorders. There is considerable interest in understanding differences in its use and trends on a global level and the macro-economic factors associated with these differences. Data on the numbers of hematopoietic stem cell transplants performed in the 3-year period 2006-2008 were obtained from Worldwide Network for Blood and Marrow Transplantation member registries and from transplant centers in countries without registries. Population and macro-economic data were collected from the World Bank and from the International Monetary Fund. Transplant rates were analyzed by indication, donor type, country, and World Health Organization regional offices areas and related to selected health care indicators using single and multiple linear regression analyses. Data from a total of 146,808 patients were reported by 1,411 teams from 72 countries over five continents. The annual number of transplants increased worldwide with the highest relative increase in the Asia Pacific region. Transplant rates increased preferentially in high income countries (P=0.02), not in low or medium income countries. Allogeneic transplants increased for myelodysplasia, chronic lymphocytic leukemia, acute leukemias, and non-malignant diseases but decreased for chronic myelogenous leukemia. Autologous transplants increased for autoimmune and lymphoproliferative diseases but decreased for leukemias and solid tumors. Transplant rates (P<0.01), donor type (P<0.01) aand disease indications (P<0.01) differed significantly between countries and regions. Transplant rates were associated with Gross National Income/capita (P<0.01) but showed a wide variation of explanatory content by donor type, disease indication and World Health Organization region. Hematopoietic stem cell transplantation activity is increasing worldwide. The preferential increase in high income countries, the widening gap between low and high income countries and the significant regional differences suggest that different strategies are required in individual countries to foster hematopoietic stem cell transplantation as an efficient and cost-effective treatment modality.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Hämatologie > Hämatologie (Passweg)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Hämatologie > Hämatologie (Passweg)
UniBasel Contributors:Gratwohl, Alois A. and Passweg, Jakob R.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Ferrata Storti Foundation
ISSN:0390-6078
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:30 Jun 2016 11:03
Deposited On:17 Mar 2016 07:42

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