The EBMT activity survey on hematopoietic-cell transplantation and cellular therapy 2018: CAR-T's come into focus

Abstract

Hematopoietic-cell transplantation (HCT) is widely used for acquired and congenital disorders of the hematopoietic system. Number of transplants performed in Europe and associated countries continues to rise with 47,468 HCT in 42,901 patients [19,630 allogeneic (41%) and 27,838 autologous (59%)] reported by 701 centers in 50 countries in 2018. Main indications were myeloid malignancies 10,679 (25%; 97% allogeneic), lymphoid malignancies 27,318 (64%; 20% allogeneic), solid tumors 1625 (4%; 2.9% allogeneic), and nonmalignant disorders 3063 (7%; 81% allogeneic). This year's analysis focuses on cellular therapies with the marked growth in CAR T-cell therapies from 151 in 2017 to 301 patients reported in 2018. Other cellular therapy numbers show less significant changes. Important trends in HCT include a 49% increase in allogeneic HCT for chronic phase CML (although transplant numbers remain low) and a 24% increase in aplastic anemia. In autologous HCT, there is an ongoing increase in autoimmune diseases (by 19%), predominantly due to activity in multiple sclerosis. This annual report reflects current activity and highlights important trends, useful for health care planning.

Fig. 1. Relative proportion of disease indications for HCT in Europe 2018.

a Relative proportion of allogeneic HCT. b Relative proportion of autologous HCT.

Fig. 2. Changes in the use of HCT for AML.

a Allogeneic HCT for AML in early and late disease. b Autologous HCT for AML in early and late disease.

Fig. 3. Transplant rates per 10 million population and absolute numbers in Europe 2018.

a Transplant rates for allogeneic HCT. b Transplant rates for autologous HCT. c Rates for patients receiving donor lymphocyte infusions. d Absolute numbers of patients receiving CAR-T cellular therapy. e Absolute numbers of patients receiving other non-CAR-T cellular therapy.