Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2010 CIBMTR Summary Slides SUM10_1.ppt.

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Presentation transcript:

Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2010 CIBMTR Summary Slides SUM10_1.ppt

Location of transplant centers participating in CIBMTR 2008 SUM10_2.ppt Slide

Transplants SUM10_3.ppt Slide 3 Transplant activity worldwide '80'81'82'83'84'85'86'87'88'89'90'91'92'93'94'95'96'97'98'99'00'01'02'03'04'05'06'07'08'09 Autologous Allogeneic 20,000 25,000 35,000 30,000 15,000 10,000 5,000 0

Transplants '80'81'82'83'84'85'86'87'88'89'90'91'92'93'94'95'96'97'98'99'00'01'02'03'04'05'06'07'08'09 Autologous Related Donor Unrelated Donor 10,000 8,000 18,000 12,000 6,000 4,000 2, ,000 14,000 SUM10_4.ppt Slide 4 Transplant activity in the U.S

Transplants, % SUM10_7.ppt Slide 5 Allogeneic stem cell sources, by recipient age Age 20 yrsAge 20 yrs Bone Marrow (BM) Peripheral Blood (PB) Cord Blood (CB)

Transplants, % SUM10_8.ppt Slide 6 Autologous stem cell sources, by recipient age Age 20 yrsAge 20 yrs Bone Marrow (BM) Peripheral Blood (PB) BM + PB

Transplants, % SUM10_9.ppt Slide 7 Trends in transplantation, by transplant type and recipient age* Allogeneic TransplantsAutologous Transplants  20 yrs yrs yrs yrs 60 yrs * Transplants for AML, ALL, NHL, Hodgkin Disease, Multiple Myeloma

Trends in transplantation, by transplant type and recipient age* Transplants, % Allogeneic TransplantsAutologous Transplants * Transplants for AML, ALL, NHL, Hodgkin Disease, Multiple Myeloma SUM10_29.ppt Slide 8  60 years  60 years  50 years  50 years

3,000 5,500 2,000 1, ,000 2,500 3,500 4,000 4,500 5,000 Indications for hematopoietic stem cell transplant in North America 2008 SUM10_11.ppt Slide 9 Number of Transplants Multiple Myeloma NHLAMLHDALLMDS/MPDAplastic Anemia CMLOther Leuk Other Cancer Non- Malig Disease Allogeneic (Total N=6,672) Autologous (Total N=10,302)

Indications for hematopoietic stem cell transplant for ages 20 years in North America 2008 SUM10_12.ppt Slide 10 Number of Transplants Number of Transplants Other Cancer ALLAMLHDMDS/MPDAplastic Anemia NHLOther Leuk Non- Malig Disease Allogeneic (Total N=1,496) Autologous (Total N=880) CML

Indications for allogeneic hematopoietic stem cell transplantation in North America 2008 SUM10_13.ppt Slide 11 3,000 2,000 1, ,000 2,500 Number of Transplants Multiple Myeloma NHLAMLHDALLMDS/MPDAplastic Anemia CMLOther Leuk Other Cancer Non- Malig Disease Related Donor (Total N=3,282) Unrelated Donor (Total N=3,389)

SUM10_14.ppt Allogeneic transplants in patients 20 years, by donor type and graft source, registered with CIBMTR, Slide 12 Number of Transplants * * Data incomplete 5,000 2,000 1, ,000 3,500 3,000 4,000 2,500 4,500 Number of Transplants Related, BM or PB Unrelated, BM or PB Unrelated, CB

SUM10_15.ppt Allogeneic transplant in patients 20 years, by donor type and graft source, registered with CIBMTR, Slide 13 Number of Transplants * * Data incomplete 13,000 7,000 6,000 2, ,000 10,000 9,000 11,000 8,000 12,000 1,000 3,000 5,000 Number of Transplants Related, BM or PB Unrelated, BM Unrelated, PB Unrelated, CB

SUM10_16.ppt Unrelated donor stem cell sources by recipient age Slide 14 Transplants, % Age 20 yrsAge 20 yrs Bone Marrow (BM) Peripheral Blood (PB) Cord Blood (CB)

SUM10_17.ppt Unrelated cord blood transplantation registered with CIBMTR Slide 15 Number of Transplants Number of Transplants * * Data incomplete  16 years  16 years

One-Year Survival, % One-year survival after myeloablative conditioning for acute leukemias in any remission phase, CML or MDS, age 50 years, by year of transplant and graft source, SUM10_18.ppt Slide Sibling Donor Unrelated Donor

SUM10_19.ppt 100-day mortality after autologous transplantation Slide 17 Mortality, % Acute LeukemiaNon-Hodgkin Lymphoma Hodgkin DiseaseMultiple Myeloma Early Disease Intermediate/Advance Disease Sensitive Resistant Other

SUM10_20.ppt 100-day mortality after HLA-identical sibling transplantation Slide 18 Mortality, % AMLCMLMDS/MPSImmune Deficiency Early Disease Intermediate Disease Advance Disease Chronic Phase Accelerated Phase Blast Phase Other ALLAplastic Anemia

SUM10_21.ppt 100-day mortality after unrelated donor transplantation Slide 19 Mortality, % AMLCMLMDS/MPSImmune Deficiency Early Disease Intermediate Disease Advance Disease Chronic Phase Accelerated Phase Blast Phase Other ALLAplastic Anemia

Causes of death after transplantations done in SUM10_22.ppt Slide 20 Infection (17%) Other Cause (19%) Organ Failure (12%) Primary Disease (35%) IPn*(5%) GVHD (12%) Infection (14%) Other (22%) GVHD (10%) Primary Disease (43%) IPn*(3%) Organ Failure (8%) Infection (5%) Other Cause (17%) Organ Failure (4%) IPn*(1%) Primary Disease (73%) *IPn = Idiopathic pneumonia syndrome Autologous Unrelated donor HLA-identical sibling

Number of Transplants 9,000 11,000 7,000 6,000 3, ,000 8,000 10,000 4,000 2,000 1, * * Data incomplete Reduced Intensity Conditioning, Age 50 years Reduced Intensity Conditioning, Age  50 years Standard Myeloablative Conditioning SUM10_23.ppt Allogeneic transplantations by conditioning regimen intensity and patient age, registered with CIBMTR Slide 21

SUM10_24.ppt Allogeneic transplantations using reduced- intensity conditioning, by donor type, registered with CIBMTR Slide 22 Number of Transplants 2,000 3,000 1, ,500 2, * * Data incomplete Unrelated CB Unrelated PB/BM Related

Transplants 2,000 3,000 1, ,500 2,500 Number of allogeneic transplants, by disease, registered with CIBMTR SUM10_25.ppt Slide * * Data incomplete AML ALL CML AA LYM / MM / CLL

SUM10_26.ppt Number of allogeneic transplants for AML, by disease status, registered with CIBMTR Slide 24 Transplants 1,400 1, , * * Data incomplete Early Disease Intermediate Disease Advanced Disease

SUM10_27.ppt Number of allogeneic transplantations for ALL, by disease status, registered with CIBMTR Slide 25 Transplants 1, * * Data incomplete Early Disease Intermediate Disease Advanced Disease

Years Probability of survival after HLA-matched sibling donor transplant for AML, by disease status, Early (N=6,898) SUM10_32.ppt Intermediate (N=1,805) Advanced (N=3,011) Probability of Survival, % P < Slide 26

Years Probability of survival after unrelated donor transplant for AML, by disease status, Early (N=3,658) SUM10_33.ppt Intermediate (N=2,774) Advanced (N=3,242) Probability of Survival, % P < Slide 27

Years Probability of survival after HLA-matched sibling donor transplant for AML, age 20 years, by disease status, Early (N=1,384) SUM09_34.ppt Intermediate (N=285) Advanced (N=309) Probability of Survival, % P < Slide 28

Years Probability of survival after HLA-matched sibling donor transplant for AML with reduced-intensity conditioning, by disease status, Early (N=1,129) SUM10_35.ppt Intermediate (N=377) Advanced (N=571) Probability of Survival, % P < Slide 29

Years Probability of survival after unrelated donor transplant for AML with reduced-intensity conditioning, by disease status, Early (N=951) SUM10_36.ppt Intermediate (N=585) Advanced (N=728) Probability of Survival, % P < Slide 30

Years Probability of survival after autologous transplant for AML, by disease status, Early (N=2,319) SUM10_38.ppt Intermediate (N=769) Advanced (N=221) Probability of Survival, % P < Slide 31

Years Probability of survival after allogeneic transplant for MDS, age 20 years, by disease status and donor type, Early, HLA-matched sibling (N=63) SUM10_39.ppt Early, unrelated (N=145) Advanced, HLA-matched sibling (N=114) Advanced, unrelated (N=190) Probability of Survival, % P = Slide 32

Years Probability of survival after allogeneic transplant for MDS, age 20 years, by disease status and donor type, Early, HLA-matched sibling (N=599) SUM10_40.ppt Early, unrelated (N=509) Advanced, HLA-matched sibling (N=1,237) Advanced, unrelated (N=1,142) Probability of Survival, % P < Slide 33

Years Probability of survival after allogeneic transplant for MDS with reduced-intensity conditioning, by disease status and donor type, SUM10_41.ppt Probability of Survival, % P < Early, unrelated (N=202) Early, HLA-matched sibling (N=217) Advanced, HLA-matched sibling (N=366) Advanced, unrelated (N=383) Slide 34

Years Early (N=915) SUM10_42.ppt Intermediate (N=1,313) Advanced (N=243) Probability of survival after HLA-matched sibling donor transplant for ALL, age 20 years, by disease status, Probability of Survival, % P < Slide 35

Years Early (N=831) SUM10_43.ppt Intermediate (N=2,041) Advanced (N=340) Probability of survival after unrelated donor transplant for ALL, age 20 years, by disease status, Probability of Survival, % P < Slide 36

Years Probability of survival after HLA-matched sibling donor transplant for ALL, age 20 years, by disease status, Early (N=1,993) SUM10_44.ppt Intermediate (N=700) Advanced (N=716) Probability of Survival, % P < Slide 37

Years Probability of survival after unrelated donor transplant for ALL, age 20 years, by disease status, Early (N=1,363) SUM09_45.ppt Intermediate (N=934) Advanced (N=784) Probability of Survival, % P < Slide 38

Years Probability of survival after HLA-matched sibling donor transplant for CML, by disease status and transplant year, SUM10_46.ppt CP, (N=2,302) Probability of Survival, % CP, (N=2,412) AP, (N=314) AP, (N=301) P < Slide 39

Years Probability of survival after autologous and HLA-matched sibling donor transplants for CLL, autologous transplant (N=399) Myeloablative conditioning(N=458) Probability of Survival, % Reduced-intensity conditioning (N=679) P < SUM10_47.ppt Slide 40

Years Probability of survival after allogeneic transplant for severe aplastic anemia, by donor type and age, HLA-matched sibling, 20 y (N=1,388) HLA-matched sibling, 20 y (N=1,408) Unrelated, 20 y (N=562) Unrelated, 20 y (N=532) Probability of Survival, % P < SUM10_48.ppt Slide 41

Years Probability of survival after autologous transplant for Hodgkin disease, by disease status, Complete remission (N=2,437) Not in CR, resistant (N=699) Probability of Survival, % P < SUM10_49.ppt Slide 42 Not in CR, sensitive (N=3,237)

Years Probability of survival after allogeneic transplant for Hodgkin disease, by donor type and conditioning regimen, HLA-matched sibling, myeloablative (N=190) Unrelated, myeloablative (N=71) Unrelated, reduced-intensity conditioning (N=110) Probability of Survival, % P = SUM10_50.ppt Slide 43 HLA-matched sibling, reduced-intensity conditioning (N=153)

Years Probability of survival after autologous transplant for follicular lymphoma, by disease status, Chemosensitive (N=1,995) Chemoresistant (N=160) Probability of Survival, % P < SUM10_51.ppt Slide 44

Years Probability of survival after HLA-matched sibling donor allogeneic transplant for follicular lymphoma, by disease status and conditioning regimen, Chemosensitive, reduced – intensity conditioning (N=388) Chemoresistant, reduced – intensity conditioning (N=64) Probability of Survival, % Chemosensitive, myeloablative (N=351) P = SUM10_52.ppt Slide 45 Chemoresistant, myeloablative (N=85)

Years Probability of survival after autologous transplant for diffuse large B-cell lymphoma, by disease status, Chemosensitive (N=6,203) Chemoresistant (N=447) Probability of Survival, % P < SUM10_53.ppt Slide 46

Years Probability of survival after HLA-matched sibling donor allogeneic transplant for diffuse large B-cell lymphoma, by disease status and conditioning regimen, Chemoresistant, myeloablative (N=98) Chemosensitive, myeloablative (N=315) Chemosensitive, reduced-intensity conditioning (N=122) Chemoresistant, reduced-intensity conditioning (N=43) Probability of Survival, % P < SUM10_54.ppt Slide 47

Years Probability of survival after transplant for mantle cell lymphoma, by donor type and conditioning regimen, autologous transplant (N=2,390) HLA-matched sibling, reduced-intensity conditioning (N=229) Unrelated, reduced-intensity conditioning (N=184) HLA-matched sibling, myeloablative (N=284) Unrelated, myeloablative (N=94) Probability of Survival, % P < SUM10_55.ppt Slide 48

Years Probability of Survival, % Probability of survival after transplant for multiple myeloma, by donor type HLA-matched sibling, Allo (N=878) autologous transplant (N=22,254) Unrelated, Allo (N=143) P < SUM10_56.ppt Slide 49