Haematopoietic stem cell transplantation: activity in Switzerland compared with surrounding European countries

J Passweg,A Gratwohl,Y Chalandon,M Stern,M Bargetzi,T Pabst,U Schanz,Ma Duchosal,C Renner,De Nicoloso,G Stussi,U Hess,H Baldomero,T Güngör,The For,K Leibundgut,C Bucher,H Ozsahin

doi:10.4414/smw.2013.13757

Abstract

Haematopoietic stem cell transplantation (HSCT) is a highly specialised procedure used to treat malignancies of the lymphohaematopoietic system as well as some acquired and inherited disorders of the blood. This analysis by the Swiss Blood Stem Cell Transplantation Group, based on data from 2008-2011, describes, treatment rates in Switzerland for specific indications and compares this with data from Germany, France, Italy and the Netherlands, corrected for the size of the population. Differences in transplant rates, in rates for particular indications, and in the use of specific transplant technologies such as use of unrelated donors, use of cord blood or mismatched family donors are described. These data are put in correlation with donor availability from international registries and with number of transplant teams and number of procedures per team all corrected for population size.

Highlights

Haematopoietic stem cell transplantation (HSCT) has become an established treatment option for a wide range of haemato-oncological tumours, some solid tumours, and nonmalignant diseases such as bone marrow failure, primary immunodeficiencies and other congenital and acquired disorders [1,2]
Differences in transplant rates, in rates for particular indications, and in the use of specific transplant technologies such as use of unrelated donors, use of cord blood or mismatched family donors are described. These data are put in correlation with donor availability from international registries and with number of transplant teams and number of procedures per team all corrected for population size
Autologous HSCT is used to bridge haematopoietic failure during high-dose chemotherapy for the treatment of tumours of the haematopoietic system and some solid tumours that are adequately sensitive to this treatment

Summary

Introduction

Haematopoietic stem cell transplantation (HSCT) has become an established treatment option for a wide range of haemato-oncological tumours, some solid tumours, and nonmalignant diseases such as bone marrow failure, primary immunodeficiencies and other congenital and acquired disorders [1,2]. Allogeneic HSCT is used to replace the haematopoietic system in patients with acquired or congenital haematopoietic failure, and more commonly to exploit the graft versus tumour effect of allogeneic cells in malignant disease [1,2,3,4]. Before HSCT, chemotherapy or chemotherapy in combination with total body irradiation is administered The goal of these conditioning regimens in autologous HSCT is to administer cytotoxic chemotherapy to the tumour, without any compromises in intensity because of marrow toxicity, but to preserve nonhaematopoietic organ function. In allogeneic HSCT marrow-ablative doses of chemotherapy and total-body irradiation were thought to be necessary to eradicate malignancy, to provide immunosuppression in the recipient, and to create space in the stem cell compartment, allowing engraftment of donor haematopoietic cells. The goal was to promote engraftment and let the graft versus tumour effect

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