Hematopoietic Stem Cell Transplant Activity in Latin America: Predominant Increase in Autologous and Modest Increase in Allogeneic HCT with High Use of Unrelated Cord Blood Grafts
Notice bibliographique
Résumé
Abstract More than a million HCT have been performed worldwide to date, but transplant rates and indications vary widely across regions. The Latin American Bone Marrow Transplantation Group (LABMT) was created under the auspices of the Worldwide Network for Blood and Marrow Transplantation (WBMT) in 2011 to assist in diffusing the practice, to integrate centers from multiple countries and to improve access to transplantation in the region. To evaluate the actual HCT activity, trends and contemporary practices in Latin America (LA), the LABMT surveyed centers for the annual activity from 2009 to 2012. Methods: The WBMT Global Activity Survey was used as a template and sent to all Hematology and HCT Societies in the region. This survey includes information of annual HCT numbers by center, indications, stem cell source and donor type. Results: A total of 11,116 HCT were performed between 2009 and 2012 with an increase in annual numbers from 2,517 in 2009 to 3,072 in 2012 (22%). The majority of the HCT were autologous (62%) with a 32% increase in activity over the period analyzed. In contrast, the increase in allogeneic HCT (6%) was relatively small. The majority of allogeneic HCT used related donors (n=3210), mostly HLA-identical peripheral blood (n=1812), bone marrow (n=1128) and non-identical related peripheral blood (n=156). Unrelated donor HCT (n=982) were performed mostly using cord blood (n=427), followed by bone marrow (n=332) and peripheral blood (n=223). In 2012, 91 teams from 12 countries reported 3,072 patients. Transplant rates (TR; HCT/10 million population) were 21 for allogeneic (ranging from 6 in Venezuela to 85 in Uruguay) and 60 for autologous HCT (ranging from 8 in Mexico to 215 in Uruguay). Unrelated donor TR was 5, ranging from 0 (Costa Rica, Panama, Peru, Paraguay and Venezuela) to 18 (Chile). Transplant center team density (team/10 million inhabitants) was 1.8 in 2012, with the highest in Uruguay (15), followed by Panama (8), Costa Rica (4), and Argentina (4). In comparison to other regions, transplant center density in LA was identical to the Asian Pacific region and lower than in Europe (7) or US/Canada (6). TR in LA compared to Asia/Pacific were higher for autologous (39 vs. 14) and lower for allogeneic (21 vs. 24, respectively, Table 1). Most transplant indications for autologous HCT (65% of all HCT) were plasma cell disorders (48%) and lymphomas (41%). Most allogeneic transplants (35% of all HCT) were performed for acute leukemias (58%, equally myeloid and lymphoid leukemias) and 18% for non-malignant disorders. Conclusion: While transplant indications are comparable to HCT performed in Europe and North America, transplant rates, transplant center and transplant team densities in LA are markedly lower. More autologous than allogeneic HCT are performed and autologous HCT increased considerably between 2009 and 2012. Unrelated donor TR is lower than in other regions. Initiatives are currently being taken to increase transplant activity, especially using alternative donor transplants within the region. Table 1. Transplant Rates and Team Density Worldwide Transplant rates (HCT/10 million population) Team density Region POP TOTAL AUTO ALLO FAMILY SIBLING UNRELATED LA 511.7 60.0 39.2 20.9 16.0 14.3 4.9 1.8 SEAR/WPR 3078.0 38.6 14.2 24.4 12.5 8.2 11.9 1.8 EUROPE 846.4 379.3 222.5 156.8 68.2 57.0 88.6 7.6 USA/Canada 348.0 482.5 264.9 217.5 91.2 75.8 126.3 6.2 EMR/AFR 690.9 29.8 12.7 17.2 15.7 15.0 1.4 0.4 HCT, hematopoietic cell transplantation; POP, population; AUTO, autologous; ALLO, allogeneic; SEAR/WPR, South East Asia/Western Pacific Region; LA, Latin America; EMR/AFR; Eastern Mediterranean/African Region Disclosures No relevant conflicts of interest to declare.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».