INDICATIONS FOR HEMATOPOIETIC PRECURSOR CELL TRANSPLANTS IN EUROPE

Information on 17 206 haemopoietic precursor cell transplants performe d in 12 European countries between 1991 and 1993 was used to assess th e number of transplants per million inhabitants per year by principal indication and donor source, 16.6 transplants were performed per milli on inhabitants per year with a range of 9.4-27.7. Differences between countries may be due to the availability of beds and resources or to d ivergent opinions about treatments. We used the coefficient of variati on (CV) to assess the degree of agreement between clinicians with rega rd to different procedures and indications, with a cut-off of less tha n or equal to 45% to indicate consensus. The rate of allogeneic transp lantation between the 12 countries was more 'homogenous' than that of autologous transplantation (mean 6.8 per million inhabitants, range 5. 2-9.5, CV 20% versus mean 9.8 per million inhabitants, range 3.6-18.4, CV 40%). Consensus was found for allografting in chronic myeloid leuk aemia (CML) in first chronic phase (CV 19%), CML in later phases (CV 3 1%), acute myeloid leukaemia (AML) in first complete remission (CV 41% ), AML beyond first complete remission (CV 34%), acute lymphoblastic l eukaemia beyond first complete remission (23%), and severe aplastic an aemia (29%). Consensus for autografting was observed for Hodgkin's dis ease (CV 44%), non-Hodgkin's lymphoma (CV 44%), and AML beyond first r emission (CV 41%). With this method an assessment of medical opinion c an be made in spite of the different availabilities of resources. Thes e data reflect the state of the art in haemopoietic precursor cell usa ge in Europe; they provide a basis for patient counselling and health- care planning.