Blood and marrow transplantation activity in Europe 1997

Data from the annual survey on transplant activity 1997, collected from 457 transplant teams in 31 European countries by the European Group for Blood and Marrow Transplantation (EBMT) were used to describe current status and to assess relative and absolute changes in indication, donor type and stem cell source compared to 1991. A total of 16 950 patients were reported to h ave a first blood or marrow transplant in 1997, a total of 18 923 procedure s, including re- and double transplants were performed. Of the 16 950 first transplants, 4751 (28%) were allogeneic, 12 199 (72%) autologous transplan ts, Of the autologous transplants, 829 (7%) were bone marrow derived, 11 37 0 (93%) from peripheral blood stem cells or combined bone marrow and periph eral blood stem cell transplants, Of the allogeneic transplants, 3311 (70%) were bone marrow, 1440 (30%) were peripheral blood stem cell transplants. In 1991, the respective figures were 2175 allogeneic (44%) and 2786 (56%) a utologous transplants, more than 90% of the autologous, all allogeneic tran splants bone marrow derived. Main indications in 1997 were leukemias with 5 253 transplants (31%), 70% allogeneic; lymphomas with 6773 transplants (40% ), 94% autologous; solid tumors with 4154 transplants (24%), 99% autologous ; non-malignant disorders with 770 transplants (5%), 85% allogeneic. There was an absolute increase of 11 971 transplants since 1991. An increase was observed in all disease categories. Marked differences were found, when the relative increase index (RII) for specific disease categories over time wa s analyzed. In allogeneic transplants, relatively more transplants were per formed in 1997 for acute myeloid leukemia beyond Ist complete remission (RI I 1.28), myelodysplastic syndromes (RII 1.58), chronic lymphocytic leukemia (RII 1.33) and non-Hodgkin's lymphoma (RII 1.58). For autologous transplan t indications, a high relative increase index was observed in myelodysplast ic syndromes (RII 3.77), in multiple myeloma (RII 2.12) and carcinoma of th e breast (RII 6.37) with a relative decrease in leukemias (RII 0.39) and ce rtain solid tumors such as glioma (RII 0.27) and neuroblastoma (RII 0.46). These data present the current status of blood and marrow transplantation i n Europe, They show the change from bone marrow to blood as stem cell sourc e and highlight shifts in indication. They provide a basis for patient coun selling and health care planning.