Transplant registries: Guiding clinical decisions and improving outcomes

About 50,000 hematopoietic stem cell transplantations are performed yearly, primarily for malignancies. Use of this therapy increased dramatically ove r the past 30 years due to its proven and potential efficacy in diverse dis eases, better understanding of appropriate timing of transplantation and pa tient selection, and greater availability of allogeneic donors. The Interna tional Bone Marrow Transplant Registry (IBMTR) and the Autologous Blood and Marrow Transplant Registry (ABMTR) collect data on consecutive allogeneic and autologous transplants, respectively, in more than 400 participating ce nters worldwide. The IBMTR/ABMTR database contains information on more than 120,000 transplant recipients. Among 11,347 patients transplanted in 101 I BMTR/ABMTR research centers in North America during 1995-1997, 66% received autologous transplants, 24% related-donor transplants, and 10% unrelated-d onor transplants. More than 90% of transplantations were for malignant dise ase, with more than half of these done in patients with advanced disease. O f the recipients, 70% were younger than 50 years. Posttransplant survivals varied substantially by disease, transplant type, recipient age, and diseas e status at transplantation. IBMTR/ABMTR data provide an important tool for assessing transplant use and outcome, identifying prognostic factors for t ransplant outcomes, evaluating new transplant therapies, comparing transpla nt and nontransplant therapies, evaluating late transplant complications, a nd planning prospective phase II and III clinical trials.