造血幹細胞移植:グローバルな視点
Alois Gratwohl1, Helen Baldomero, Mahmoud Aljurf
1European Group for Blood andMarrow Transplantation, Transplant Activity Survey Office, Department of Hematology, University Hospital Basel, Basel, Switzerland. hematology@uhbs.ch
JAMA
|April 29, 2010
まとめ
血液形成性幹細胞移植 (HSCT) は,世界中の様々な状態のために使用されています. 高所得国,医療費の増加,移植チームが増えることが,高水準のHSCT率の上昇と相関しています.
科学分野:
- 血液学 ヘマトロジ
- 移植医療 移植医療 移植医療
- グローバル・ヘルス グローバル・ヘルス
背景:
- 血液形成性幹細胞移植 (HSCT) は,かなりのリソースを必要とする複雑な手順です.
- HSCTの利用と影響要因に関する世界的なデータは依然として限られています.
研究 の 目的:
- 世界中でHSCTの使用を分析する.
- 異なる地域におけるHSCTの適用における格差を特定する.
- 世界的にマクロ経済指標とHSCT率の関係を探求する.
主な方法:
- 2006年に71カ国の1327のセンターを回顧調査したものです.
- アロゲンおよびオトログのHSCT手順で収集されたデータ.
- 移植率,徴候,ドナーの種類,マクロ経済要因の分析.
主要な成果:
- 5万件以上の最初のHSCTが実施され,57%がオトログで43%がオロジェニックでした.
- HSCTの割合は,地域によって著しく変化し,ヨーロッパが最も高い平均率を示しています.
- HSCTは,人口が30万人未満,土地面積が小さい,または一人当たりの国民総所得が低い (<680ドル) の国々では実施されなかった.
- 政府保健費,HSCTチーム密度,人間開発指数,国民一人当たりの総国民所得は,HSCT率と強く関連していました.
結論:
- 造血幹細胞移植は,世界中で幅広い疾患に適用されています.
- 健全な医療制度と確立された移植インフラストラクチャを持つ高所得国は,HSCTをより頻繁に利用しています.
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