Related Experiment Videos
The international bone marrow transplant registry
Insights
Hematopoietic stem cell transplants, first performed in 1968, treat immune deficiencies and other diseases. Global transplant numbers are rising due to improved efficacy, donor availability, and supportive care.
Area of Science:
- Hematology
- Immunology
- Transplant Medicine
Background:
- The first hematopoietic stem cell transplants (HSCT) occurred in 1968 for congenital immune deficiencies.
- Since then, HSCT has become a vital treatment for numerous malignant and non-malignant diseases.
Purpose of the Study:
- To provide an overview of the historical development and current status of hematopoietic stem cell transplantation.
- To highlight the factors contributing to the increasing use and improved outcomes of HSCT.
Main Methods:
- Review of historical data and current estimates of HSCT procedures worldwide.
- Analysis of factors influencing the growth and success rates of HSCT.
Main Results:
- Approximately 50,000 HSCT procedures are performed annually worldwide, with a 10-15% annual growth rate.
- Autologous HSCT accounts for two-thirds of procedures, often using peripheral blood stem cells.
- Allogeneic HSCT, frequently from HLA-identical siblings using bone marrow, comprises the remainder.
Conclusions:
- Hematopoietic stem cell transplantation has evolved significantly since its inception.
- Improvements in efficacy, patient selection, donor matching, cell collection, and supportive care are driving the increasing utilization and success of HSCT.
Abstract:
The first successful transplants of hematopoietic stem cells were done in 1968 in three children with congenital immune deficiency diseases. In each instance, stem cells were collected from the bone marrow of sibling donors who were genotypically HLA identical or closely HLA matched to the recipient. Since then, thousands of patients have received hematopoietic stem cell transplants to treat malignant and non-malignant diseases. Current estimates of annual numbers of stem cell transplants are about 50,000 worldwide, with growth at a rate of 10-15% per year. The reasons for increasing use include proven and potential efficacy in many diseases, better understanding of the appropriate timing of transplantation and patient selection, greater availability of donors and better techniques for determining HLA match, greater ease of stem cell collection, and improved supportive care resulting in less transplant-related morbidity and mortality. About two-thirds of hematopoietic stem cell transplants use autologous cells, generally collected from peripheral blood by leukapheresis. The remainder are allogeneic transplants, most commonly from HLA-identical sibling donors, and most often using cells collected directly from bone marrow.