The Worldwide Network of Blood and Marrow Transplantation (WBMT) recently released a study reporting on the global activity trends of hematopoietic stem cell transplantation (HSCT) between 2014 and 2016 compared with 2006, with a focus on global trends in equity of access, in both indications of transplant and in donor type.
Using data from 1,662 HSCT teams in 86 of the 195 World Health Organization member states, there were 82,718 first HSCTs reported in 2016. This was a global increase of 6.2% in autologous HSCT and 7.0% in allogeneic HSCT.
“HSCT activities continue to increase worldwide without plateau and exceeded 80,000 procedures annually for the first time in 2016 and are expected to exceed 90,000 in 2018 to reach a total of 1.5 million by 2019,” the researchers wrote.
Assuming a frequency of 84,000 HSCT per year, 1.5 million HSCTs were performed from 1957 to 2019. The most frequent indications for HSCT were lymphoproliferative disorders and leukemia; however, non-malignant disorders now account for 7.3% of all HSCTs, the researchers noted. They also noted an increase in haploidentical related HSCT for leukemia and lymphoproliferative disease, but even more in non-malignant diseases.
The rate of transplant varied by geographic region. An estimated 560.8 million got HSCT in North American, 438.5 million in Europe, 76.7 million in Latin America, 53.6 million in Southeast Asia/Western Pacific (SEA/WPR), and 27.8 million in African/East Mediterranean (AFR/EMR). Haploidentical transplant rates were a greater proportion of transplants in SEA/WPR (32%) and Latin America (26%) compared with Europe and EMR (14%) and North American (4.9%).
The analysis also looked at the make up of HSCT teams in each geographic area. Team density (teams/10 million population) was highest in Europe (7.7) followed by North American (6.0), SEA/WPR (1.9), Latin America (1.6), and AFR/EMR (0.4).
The researchers noted that increasing team numbers might be difficult.
“This is due in part to the funds allocated to local health expenditure, but also due to limitations in the infrastructure required including blood banks, intensive care units, multidisciplinary teams, and microbiology expertise,” they wrote. “Shortages and unavailability of medicines and lack of trained biomechanical/biotechnical technicians have also hindered HSCT activities in developing countries.”
In all, they concluded that “the achievements obtained in the last decade should be an incentive to continue and even increase the common efforts to improve access and close the gap worldwide faster.”
Niederwieser D, Baldomero H, Bazuaye N, et al. One and a half million hematopoietic stem cell transplants: continuous and differential improvement in worldwide access with the use of non-identical family donors. Haematologica. 2022. doi:10.3324/haematol.2021.279189