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Multicenter Study
. 2019 Oct;98(10):2389-2398.
doi: 10.1007/s00277-019-03771-2. Epub 2019 Aug 7.

Trends in the use of hematopoietic stem cell transplantation for adults with acute lymphoblastic leukemia in Europe: a report from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

Sebastian Giebel  1 , Ariane Boumendil  2   3 , Myriam Labopin  2   3 , Anouchka Seesaghur  4 , Frederic Baron  5 , Fabio Ciceri  6 , Jordi Esteve  7 , Norbert-Claude Gorin  2   3 , Bipin Savani  8 , Christoph Schmid  9 , Sally Wetten  4 , Mohamad Mohty  2 , Arnon Nagler  3   10
Affiliations
Multicenter Study

Trends in the use of hematopoietic stem cell transplantation for adults with acute lymphoblastic leukemia in Europe: a report from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

Sebastian Giebel et al. Ann Hematol. 2019 Oct.

Abstract

Hematopoietic stem cell transplantation (HSCT) is considered an effective way to prevent relapse in adults with acute lymphoblastic leukemia (ALL). This study aimed to assess general trends in the use of various types of HSCTs performed between 2001 and 2015 in Europe, based on data reported to the European Society for Blood and Marrow Transplantation registry. We also evaluated HSCT rates with respect to ALL incidence in selected countries. Altogether, 15,346 first allogeneic (n = 13,460) or autologous (n = 1886) HSCTs were performed in the study period. Comparing 2013-2015 and 2001-2003, the number of allogeneic HSCTs performed in first complete remission increased by 136%, most prominently for transplantations from unrelated (272%) and mismatched related donors (339%). The number of HSCTs from matched sibling donors increased by 42%, while the total number of autologous HSCTs decreased by 70%. Increased use of allogeneic HSCT was stronger for Philadelphia chromosome (Ph)-positive (166%) than for Ph-negative ALL (38%) and for patients aged > 55 years (599%) than for younger adults (59%). The proportion of allogeneic HSCT with reduced-intensity conditioning (RIC) increased from 6 to 27%. The age-standardized rates of allogeneic HSCT per ALL incidence varied strongly among countries. Our analysis showed a continued trend toward increased allogeneic HSCT use for adults with ALL, which may be attributed to increasing availability of unrelated donors, wider use of RIC regimens, and improving efficacy of pretransplant therapy, including tyrosine kinase inhibitors for Ph-positive ALL. Allogeneic HSCT remains a major tool in the fight against ALL in adults.

Keywords: Acute lymphoblastic leukemia; Allogeneic hematopoietic stem cell transplantation; Autologous hematopoietic stem cell transplantation; Incidence.

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Conflict of interest statement

SG has received honoraria for speaking at symposia and has participated in advisory boards for Amgen. AS and SW are employees of Amgen and own shares in Amgen. MM has received honoraria for speaking for Amgen and Pfizer. All other authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Trends in the use of HSCT according to donor type and disease stage at transplantation. a All allogeneic HSCT. b Matched sibling donor HSCT. c Unrelated donor HSCT. d Mismatched related donor HSCT. e Autologous HSCT. CR complete remission; CR1 first CR, CR > 1 s or subsequent CR; HSCT hematopoietic stem cell transplantation
Fig. 2
Fig. 2
Age-standardized rates of first allogeneic HSCT performed in first complete remission for ALL in selected European countries. ALL acute lymphoblastic leukemia, HSCT hematopoietic stem cell transplantation
See this image and copyright information in PMC

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