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Ann Hematol. 2019 Oct;98(10):2389-2398. doi: 10.1007/s00277-019-03771-2. Epub 2019 Aug 7.

Trends in the use of hematopoietic stem cell transplantation for adults with acute lymphoblastic leukemia in Europe: a report from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT).

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Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Str. Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
Clinical Hematology and Cellular Therapy Department, Hospital Saint-Antoine, 84 Rue du Faubourg Saint-Antoine, 75012, Paris, France.
EBMT Acute Leukemia Working Party Office, Hospital Saint-Antoine, 84 Rue du Faubourg Saint-Antoine, 75012, Paris, France.
Amgen Limited, 1 Uxbridge Business Park, Sanderson Road, Uxbridge, London, UB8 1DH, UK.
Department of Hematology, CHU Sart-Tilman, University of Liège, Avenue de L'Hòpital 1, 4000, Liège, Belgium.
Hematology and BMT Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina Milano, 60, Segrate, 20132, Milan, Italy.
Hematology Department, IDIBAPS, Hospital Clinic, Carrer del Rosselló, 149, 08036, Barcelona, Spain.
Department of Hematology & Transplantation, Vanderbilt University, 2201 West End Ave, Nashville, TN, 37235, USA.
Department of Hematology and Oncology, Klinikum Augsburg, Ludwig-Maximilians-Universitaet Munich, Stenglinstraße 2, 86156, Augsburg, Germany.
Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-HaShomer, Derech Sheba 2, Ramat Gan, Israel.


Hematopoietic stem cell transplantation (HSCT) is considered an effective way to prevent relapse in adults with acute lymphoblastic leukemia (ALL). This study aimed to assess general trends in the use of various types of HSCTs performed between 2001 and 2015 in Europe, based on data reported to the European Society for Blood and Marrow Transplantation registry. We also evaluated HSCT rates with respect to ALL incidence in selected countries. Altogether, 15,346 first allogeneic (n = 13,460) or autologous (n = 1886) HSCTs were performed in the study period. Comparing 2013-2015 and 2001-2003, the number of allogeneic HSCTs performed in first complete remission increased by 136%, most prominently for transplantations from unrelated (272%) and mismatched related donors (339%). The number of HSCTs from matched sibling donors increased by 42%, while the total number of autologous HSCTs decreased by 70%. Increased use of allogeneic HSCT was stronger for Philadelphia chromosome (Ph)-positive (166%) than for Ph-negative ALL (38%) and for patients aged > 55 years (599%) than for younger adults (59%). The proportion of allogeneic HSCT with reduced-intensity conditioning (RIC) increased from 6 to 27%. The age-standardized rates of allogeneic HSCT per ALL incidence varied strongly among countries. Our analysis showed a continued trend toward increased allogeneic HSCT use for adults with ALL, which may be attributed to increasing availability of unrelated donors, wider use of RIC regimens, and improving efficacy of pretransplant therapy, including tyrosine kinase inhibitors for Ph-positive ALL. Allogeneic HSCT remains a major tool in the fight against ALL in adults.


Acute lymphoblastic leukemia; Allogeneic hematopoietic stem cell transplantation; Autologous hematopoietic stem cell transplantation; Incidence


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