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

2. Location of transplant centers participating in CIBMTR 2008 SUM10_2.ppt............................................................................................................................................................................................................................................................. Slide 2......................

3. Transplants SUM10_3.ppt Slide 3 Transplant activity worldwide 1980-2009 '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

4. 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 0 16,000 14,000 SUM10_4.ppt Slide 4 Transplant activity in the U.S. 1980-2009

5. Transplants, % 80 100 60 40 20 0 SUM10_7.ppt Slide 5 Allogeneic stem cell sources, by recipient age 1999-2008 Age 20 yrsAge 20 yrs 1999-20032004-20081999-20032004-2008 Bone Marrow (BM) Peripheral Blood (PB) Cord Blood (CB)

6. Transplants, % 80 100 60 40 20 0 SUM10_8.ppt Slide 6 Autologous stem cell sources, by recipient age 1999-2008 Age 20 yrsAge 20 yrs 1999-20032004-20081999-20032004-2008 Bone Marrow (BM) Peripheral Blood (PB) BM + PB

7. Transplants, % 80 100 60 40 20 0 SUM10_9.ppt Slide 7 Trends in transplantation, by transplant type and recipient age* 1999-2008 Allogeneic TransplantsAutologous Transplants 1999-20032004-20081999-20032004-2008  20 yrs 21-40 yrs 41-50 yrs 51-60 yrs 60 yrs * Transplants for AML, ALL, NHL, Hodgkin Disease, Multiple Myeloma

8. Trends in transplantation, by transplant type and recipient age* 1999-2008 Transplants, % 80 100 60 40 20 0 Allogeneic TransplantsAutologous Transplants 1995-20012002-20081988-19941995-20012002-20081988-1994 * Transplants for AML, ALL, NHL, Hodgkin Disease, Multiple Myeloma SUM10_29.ppt Slide 8  60 years  60 years  50 years  50 years

9. 3,000 5,500 2,000 1,500 500 0 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)

10. Indications for hematopoietic stem cell transplant for ages 20 years in North America 2008 SUM10_12.ppt Slide 10 Number of Transplants 600 800 400 300 100 0 200 500 700 Number of Transplants Other Cancer ALLAMLHDMDS/MPDAplastic Anemia NHLOther Leuk Non- Malig Disease Allogeneic (Total N=1,496) Autologous (Total N=880) CML

11. Indications for allogeneic hematopoietic stem cell transplantation in North America 2008 SUM10_13.ppt Slide 11 3,000 2,000 1,500 500 0 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)

12. SUM10_14.ppt Allogeneic transplants in patients 20 years, by donor type and graft source, registered with CIBMTR, 1991-2008 Slide 12 Number of Transplants * * Data incomplete 5,000 2,000 1,500 500 0 1,000 3,500 3,000 4,000 2,500 4,500 Number of Transplants 1991-92 1993-941995-961997-981999-002001-022003-042005-062007-08 Related, BM or PB Unrelated, BM or PB Unrelated, CB

13. SUM10_15.ppt Allogeneic transplant in patients 20 years, by donor type and graft source, registered with CIBMTR, 1991-2008 Slide 13 Number of Transplants * * Data incomplete 13,000 7,000 6,000 2,000 0 4,000 10,000 9,000 11,000 8,000 12,000 1,000 3,000 5,000 Number of Transplants 1991-92 1993-941995-961997-981999-002001-022003-042005-062007-08 Related, BM or PB Unrelated, BM Unrelated, PB Unrelated, CB

14. SUM10_16.ppt Unrelated donor stem cell sources by recipient age 1999-2008 Slide 14 Transplants, % 80 100 60 40 20 0 Age 20 yrsAge 20 yrs 1999-20032004-20081999-20032004-2008 Bone Marrow (BM) Peripheral Blood (PB) Cord Blood (CB)

15. SUM10_17.ppt Unrelated cord blood transplantation registered with CIBMTR 1999-2008 Slide 15 Number of Transplants 600 800 400 300 100 0 200 500 700 Number of Transplants 1999 200020012002200320042005200720082006 * * Data incomplete  16 years  16 years

16. 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, 1988-2008 SUM10_18.ppt Slide 16 1988-90199119921993199419951996199719981999200020012002200320042005200620072008 Sibling Donor Unrelated Donor 40 60 100 80 20 0

17. SUM10_19.ppt 100-day mortality after autologous transplantation 2007-2008 Slide 17 Mortality, % 12 15 9 6 3 0 Acute LeukemiaNon-Hodgkin Lymphoma Hodgkin DiseaseMultiple Myeloma Early Disease Intermediate/Advance Disease Sensitive Resistant Other

18. SUM10_20.ppt 100-day mortality after HLA-identical sibling transplantation 2007-2008 Slide 18 Mortality, % 80 100 60 40 20 0 AMLCMLMDS/MPSImmune Deficiency Early Disease Intermediate Disease Advance Disease Chronic Phase Accelerated Phase Blast Phase Other ALLAplastic Anemia

19. SUM10_21.ppt 100-day mortality after unrelated donor transplantation 2007-2008 Slide 19 Mortality, % 80 100 60 40 20 0 AMLCMLMDS/MPSImmune Deficiency Early Disease Intermediate Disease Advance Disease Chronic Phase Accelerated Phase Blast Phase Other ALLAplastic Anemia

20. Causes of death after transplantations done in 2003-2008 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

21. Number of Transplants 9,000 11,000 7,000 6,000 3,000 0 5,000 8,000 10,000 4,000 2,000 1,000 1999 200020012002200320042005200720082006 * * 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 1999-2008 Slide 21

22. SUM10_24.ppt Allogeneic transplantations using reduced- intensity conditioning, by donor type, registered with CIBMTR 1998-2008 Slide 22 Number of Transplants 2,000 3,000 1,000 500 0 1,500 2,500 1999 200020012002200320042005200720082006 * * Data incomplete Unrelated CB Unrelated PB/BM Related

23. Transplants 2,000 3,000 1,000 500 0 1,500 2,500 Number of allogeneic transplants, by disease, registered with CIBMTR 1998-2008 SUM10_25.ppt Slide 23 1999 200020012002200320042005200720082006 * * Data incomplete AML ALL CML AA LYM / MM / CLL

24. SUM10_26.ppt Number of allogeneic transplants for AML, by disease status, registered with CIBMTR 1998-2008 Slide 24 Transplants 1,400 1,200 600 0 1,000 800 400 200 1999 200020012002200320042005200720082006 * * Data incomplete Early Disease Intermediate Disease Advanced Disease

25. SUM10_27.ppt Number of allogeneic transplantations for ALL, by disease status, registered with CIBMTR 1998-2008 Slide 25 Transplants 1,000 600 0 800 400 200 1999 200020012002200320042005200720082006 * * Data incomplete Early Disease Intermediate Disease Advanced Disease

26. Years 026 13 45 Probability of survival after HLA-matched sibling donor transplant for AML, by disease status, 1998-2008 Early (N=6,898) SUM10_32.ppt Intermediate (N=1,805) Advanced (N=3,011) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 26

27. Years 026 13 45 Probability of survival after unrelated donor transplant for AML, by disease status, 1998-2008 Early (N=3,658) SUM10_33.ppt Intermediate (N=2,774) Advanced (N=3,242) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 27

28. Years 026 13 45 Probability of survival after HLA-matched sibling donor transplant for AML, age 20 years, by disease status, 1998-2008 Early (N=1,384) SUM09_34.ppt Intermediate (N=285) Advanced (N=309) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 28

29. Years 026 13 45 Probability of survival after HLA-matched sibling donor transplant for AML with reduced-intensity conditioning, by disease status, 1998-2008 Early (N=1,129) SUM10_35.ppt Intermediate (N=377) Advanced (N=571) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 29

30. Years 026 13 45 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of survival after unrelated donor transplant for AML with reduced-intensity conditioning, by disease status, 1998-2008 Early (N=951) SUM10_36.ppt Intermediate (N=585) Advanced (N=728) Probability of Survival, % P < 0.0001 Slide 30

31. Years 026 13 45 Probability of survival after autologous transplant for AML, by disease status, 1998-2008 Early (N=2,319) SUM10_38.ppt Intermediate (N=769) Advanced (N=221) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 31

32. Years 026 13 45 Probability of survival after allogeneic transplant for MDS, age 20 years, by disease status and donor type, 1998-2008 Early, HLA-matched sibling (N=63) SUM10_39.ppt Early, unrelated (N=145) Advanced, HLA-matched sibling (N=114) Advanced, unrelated (N=190) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P = 0.002 Slide 32

33. Years 026 13 45 Probability of survival after allogeneic transplant for MDS, age 20 years, by disease status and donor type, 1998-2008 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) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 33

34. Years 026 13 45 Probability of survival after allogeneic transplant for MDS with reduced-intensity conditioning, by disease status and donor type, 1998-2008 SUM10_41.ppt 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Early, unrelated (N=202) Early, HLA-matched sibling (N=217) Advanced, HLA-matched sibling (N=366) Advanced, unrelated (N=383) Slide 34

35. Years 026 13 45 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, 1998-2008 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 35

36. Years 026 13 45 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, 1998-2008 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 36

37. Years 026 13 45 Probability of survival after HLA-matched sibling donor transplant for ALL, age 20 years, by disease status, 1998-2008 Early (N=1,993) SUM10_44.ppt Intermediate (N=700) Advanced (N=716) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 37

38. Years 026 13 45 Probability of survival after unrelated donor transplant for ALL, age 20 years, by disease status, 1998-2008 Early (N=1,363) SUM09_45.ppt Intermediate (N=934) Advanced (N=784) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 Slide 38

39. Years Probability of survival after HLA-matched sibling donor transplant for CML, by disease status and transplant year, 1998-2008 026 13 45 SUM10_46.ppt CP, 1998-2000 (N=2,302) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % CP, 2001-2008 (N=2,412) AP, 2001-2008 (N=314) AP, 1998-2000 (N=301) P < 0.0001 Slide 39

40. Years 026 13 45 Probability of survival after autologous and HLA-matched sibling donor transplants for CLL, 1998-2008 autologous transplant (N=399) Myeloablative conditioning(N=458) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % Reduced-intensity conditioning (N=679) P < 0.0001 SUM10_47.ppt Slide 40

41. Years 026 13 45 Probability of survival after allogeneic transplant for severe aplastic anemia, by donor type and age, 1998-2008 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) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 SUM10_48.ppt Slide 41

42. Years 026 13 45 Probability of survival after autologous transplant for Hodgkin disease, by disease status, 1998-2008 Complete remission (N=2,437) Not in CR, resistant (N=699) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 SUM10_49.ppt Slide 42 Not in CR, sensitive (N=3,237)

43. Years 026 13 45 Probability of survival after allogeneic transplant for Hodgkin disease, by donor type and conditioning regimen, 1998-2008 HLA-matched sibling, myeloablative (N=190) Unrelated, myeloablative (N=71) Unrelated, reduced-intensity conditioning (N=110) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P = 0.021 SUM10_50.ppt Slide 43 HLA-matched sibling, reduced-intensity conditioning (N=153)

44. Years 026 13 45 Probability of survival after autologous transplant for follicular lymphoma, by disease status, 2000-2008 Chemosensitive (N=1,995) Chemoresistant (N=160) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 SUM10_51.ppt Slide 44

45. Years 026 13 45 Probability of survival after HLA-matched sibling donor allogeneic transplant for follicular lymphoma, by disease status and conditioning regimen, 1998-2008 Chemosensitive, reduced – intensity conditioning (N=388) Chemoresistant, reduced – intensity conditioning (N=64) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % Chemosensitive, myeloablative (N=351) P = 0.011 SUM10_52.ppt Slide 45 Chemoresistant, myeloablative (N=85)

46. Years 026 13 45 Probability of survival after autologous transplant for diffuse large B-cell lymphoma, by disease status, 2000-2008 Chemosensitive (N=6,203) Chemoresistant (N=447) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 SUM10_53.ppt Slide 46

47. Years 026 13 45 Probability of survival after HLA-matched sibling donor allogeneic transplant for diffuse large B-cell lymphoma, by disease status and conditioning regimen, 1998-2008 Chemoresistant, myeloablative (N=98) Chemosensitive, myeloablative (N=315) Chemosensitive, reduced-intensity conditioning (N=122) Chemoresistant, reduced-intensity conditioning (N=43) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 SUM10_54.ppt Slide 47

48. Years 026 13 45 Probability of survival after transplant for mantle cell lymphoma, by donor type and conditioning regimen, 1998-2008 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) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 Probability of Survival, % P < 0.0001 SUM10_55.ppt Slide 48

49. Years 026 13 45 Probability of Survival, % Probability of survival after transplant for multiple myeloma, by donor type 1998-2008 HLA-matched sibling, Allo (N=878) autologous transplant (N=22,254) Unrelated, Allo (N=143) 0 20 40 60 80 100 10 30 50 70 90 0 20 40 60 80 100 10 30 50 70 90 P < 0.0001 SUM10_56.ppt Slide 49