HEMATOPOIETIC STEM CELL TRANSPLANTATION IN SYSTEMIC SCLEROSIS
Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2011 Summary Slides Worldwide...
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Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2011 Summary Slides Worldwide SUM-WW11_1.ppt
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Transcript of Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2011 Summary Slides Worldwide...
Current Uses and Outcomes of Hematopoietic
Stem Cell Transplantation2011
Summary SlidesWorldwide
SUM-WW11_1.ppt
Location of Centers participating in the CIBMTR
2011
SUM-WW11_2.ppt
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Slide 2
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Transp
lants
SUM11_41.ppt
Slide 3
Transplant Activity in the U.S.1980-2010
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
'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 '10
AutologousRelated DonorUnrelated Donor
SUM-WW11_3.ppt
Allogeneic Stem Cell Sourcesby Recipient Age
2000-2009
Age £ 20 yrs Age > 20 yrs
Slide 4
Transp
lants
, %
0
20
40
60
80
100
2000-2004 2005-2009 2000-2004 2005-2009
Bone Marrow (BM)
Peripheral Blood (PB)
Cord Blood (CB)
SUM-WW11_4.ppt
Autologous Stem Cell Sourcesby Recipient Age
2000-2009
Age £ 20 yrs Age > 20 yrs
Slide 5
Transp
lants
, %
0
20
40
60
80
100
2000-2004 2005-2009 2000-2004 2005-2009
Bone Marrow (BM)Peripheral Blood (PB)BM + PB
SUM-WW11_5.ppt
Trends in Transplantsby Type and Recipient Age*
2000-2009
* Transplants for AML, ALL, NHL, Hodgkin Disease, Multiple Myeloma Slide 6
Transp
lants
, %
Allogeneic Transplants Autologous Transplants
0
20
40
60
80
100
2000-2004 2005-2009 2000-2004 2005-2009
<=20 yrs21-40 yrs41-50 yrs51-60 yrs>60 yrs
0
20
40
60
80
100
1989-1995 1996-2002 2003-2009 1989-1995 1996-2002 2003-2009
< 50 years>= 50 years
<60 years>=60 years
SUM11_5.ppt
Trends in Transplantsby Transplant Type and Recipient Age*
1989-2009
* Transplants for AML, ALL, NHL, Hodgkin Disease, Multiple Myeloma Slide 7
Transp
lants
, %
Allogeneic Transplants Autologous Transplants
Indications for Hematopoietic Stem Cell Transplants in the United States, 2009
SUM-WW11_8.ppt
Slide 8
Num
ber
of
Transp
lants
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
5,500
MultipleMyeloma
NHL AML HD ALL MDS/MPD AplasticAnemia
CML OtherLeuk
Non-Malig
Disease
OtherCancer
Allogeneic (Total N=7,012)
Autologous (Total N=9,778)
Indications for Hematopoietic Stem Cell Transplants for Age £ 20yrs in the United States, 2009
SUM-WW11_9.ppt
Slide 9
Num
ber
of
Transp
lants
0
100
200
300
400
500
600
700
OtherCancer
ALL AML AplasticAnemia
MDS/MPS HD NHL CML OtherLeuk
Non-Malig
Disease
Allogeneic (Total N=1,815)
Autologous (Total N=787)
SUM-WW11_10.ppt
Allogeneic Transplants for Age £ 20yrs,Registered with the CIBMTR
1992-2009- by Donor Type and Graft Source -
Slide 10
Num
ber
of
Transp
lants
*
* Data incomplete
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
1992-93 1994-95 1996-97 1998-99 2000-01 2002-03 2004-05 2006-07 2008-09
Related BM/PBUnrelated BM/PBUnrelated CB
SUM-WW11_11.ppt
Allogeneic Transplants for Age > 20yrs,Registered with the CIBMTR
1992-2009- by Donor Type and Graft Source -
Slide 11
Num
ber
of
Transp
lants
*
* Data incomplete
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
11,000
12,000
13,000
1992-93 1994-95 1996-97 1998-99 2000-01 2002-03 2004-05 2006-07 2008-09
Related BM/PBUnrelated BMUnrelated PBUnrelated CB
SUM-WW11_12.ppt
Unrelated Donor Stem Cell Sourcesby Recipient Age
2000-2009
Age £ 20 yrs Age > 20 yrs
Slide 12
Transp
lants
, %
0
20
40
60
80
100
2000-2004 2005-2009 2000-2004 2005-2009
Bone Marrow (BM)
Peripheral Blood (PB)
Cord Blood (CB)
SUM-WW11_13.ppt
Unrelated Cord Blood Transplants, by AgeRegistered with the CIBMTR
2000-2009
Slide 13
Num
ber
of
Transp
lants
*
* Data incomplete
0
100
200
300
400
500
600
700
800
900
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
>= 16 years< 16 years
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, 1988-2009
One-Y
ear
Surv
ival, %
SUM11_40.ppt
Slide 14
0
20
40
60
80
100
1988-90
'91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09
HLA-matched siblingUnrelated Donor
SUM-WW11_14.ppt
100-day Mortality after Autologous Transplants,
2008-2009
Slide 15
Mort
alit
y, %
0
10
20
30
40
50
Acute Leukemia Non-HodgkinLymphoma
HodgkinDisease
MultipleMyeloma
Early DiseaseIntermediate/Advance DiseaseSensitiveResistantUnknownOther
0
20
40
60
80
100
AML ALL CML MDS/MPS AplasticAnemia
ImmuneDeficiency
SUM-WW11_15.ppt
100-day Mortality after HLA-identical Sibling Transplants,
2008-2009
Slide 16
Early DiseaseIntermediate DiseaseAdvanced DiseaseChronic PhaseAccelerated PhaseBlast PhaseOther
Mort
alit
y, %
0
20
40
60
80
100
AML ALL CML MDS/MPS AplasticAnemia
ImmuneDeficiency
SUM-WW11_16.ppt
100-day Mortality after Unrelated Donor Transplants,
2008-2009
Slide 17
Early DiseaseIntermediate DiseaseAdvanced DiseaseChronic PhaseAccelerated PhaseBlast PhaseOther
Mort
alit
y, %
Causes of Death after Transplants
performed in2008-2009
Autologous
Infection (8%)
Other (16%)
Organ Failure (2%)
New Malignancy (1%)
Primary Disease (73%)
Unrelated Donor
Infection (16%)
Other (29%)Organ
Failure (6%)
Primary Disease(33%)
New Malignancy (1%)
GVHD (15%)
SUM-WW11_17.ppt
Slide 18
HLA-identical Sibling
Infection (12%)
Other (21%)
Primary Disease (47%)
GVHD (14%)
Organ Failure (4%)
New Malignancy (1%)
SUM-WW11_18.ppt
Allogeneic Transplants, Registered with the CIBMTR, 2000-2009
- by Conditioning Regimen Intensity & Age -
*
* Data incomplete
Slide 19
Num
ber
of
Transp
lants
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
11,000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Reduced Intensity Conditioning, Age >=50 yrsReduced Intensity Conditioning, Age < 50 yrsStandard Myeloablative Conditioning
SUM-WW11_19.ppt
Allogeneic Transplants after Reduced-intensity Conditioning, by Donor Type,
Registered with CIBMTR 1998-2009
* *
* Data incomplete
Slide 20
Num
ber
of
Transp
lants
0
500
1,000
1,500
2,000
2,500
3,000
1998-99 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Unrelated CBUnrelated PB/BMRelated
Years
0 2 61 3 4 5
Probability of Survival after HLA-identical Sibling Donor Transplants for AML
2000-2009- By Disease Status -
Early (N=6,317)
Intermediate (N=1,675)
Advanced (N=2,645)
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_20.ppt
Slide 21
Years
0 2 61 3 4 5
Probability of Survival after Unrelated Donor Transplants for AML, 2000-2009
- By Disease Status -
Early (N=4,260)
Intermediate (N=2,864)
Advanced (N=3,173)
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_21.ppt
Slide 22
Years
0 2 61 3 4 5
Probability of Survival after HLA-identical Sibling Donor Transplants for AML, Age <20yrs,
2000-2009- by Disease Status -
Early (N=1,176)
Intermediate (N=239)
Advanced (N=250)
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_22.ppt
Slide 23
Years
0 2 61 3 4 5
Probability of Survival after Autologous Transplants for AML, 2000-2009
- by Disease Status -
Early (N=1,979)
Intermediate (N=672)
Advanced (N=139)
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_23.ppt
Slide 24
Years
0 2 61 3 4 5
Probability of Survival after Allogeneic Transplants for MDS
2000-2009- by Disease Status and Donor Type -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_24.ppt
Slide 25
Early, sibling donor (N=667)
Early, unrelated donor (N=752)
Advanced, sibling donor (N=1,188)
Advanced, unrelated donor (N=1,400)
Years
0 2 61 3 4 5
Probability of Survival after HLA-identical Sibling Donor Transplants for ALL, Age < 20yrs
2000-2009- by Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_25.ppt
Slide 26
Early (N=777)
Intermediate (N=1,092)
Advanced (N=196)
Years
0 2 61 3 4 5
Probability of Survival after Unrelated Donor Transplants for ALL, Age < 20yrs,
2000-2009- By Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_26.ppt
Slide 27
Intermediate (N=1,832)
Advanced (N=278)
Early (N=848)
Years
0 2 61 3 4 5
Probability of Survival after HLA-identical Sibling Donor Transplants for ALL,
Age ³ 20yrs, 2000-2009- By Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM11_27.ppt
Slide 28
Intermediate (N=627)
Advanced (N=568)
Early (N=1,918)
Years
0 2 61 3 4 5
Probability of Survival after Unrelated Donor Transplants for ALL, Age ³ 20yrs,
2000-2009- By Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_28.ppt
Slide 29
Intermediate (N=928)
Advanced (N=700)
Early (N=1,458)
Years
0 2 61 3 4 5
Probability of Survival after HLA-identical Sibling Donor Transplants for CML,
1998-2009- By Disease Status and Transplant Year -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_29.ppt
Slide 30
CP, 1998-2000 (N=2,291)
AP, 1998-2000 (N=300)
CP, 2001-2009 (N=2,524)
AP, 2001-2009 (N=333)
Years
0 2 61 3 4 5
Probability of Survival after Autologous and HLA-matched Sibling Donor Hematopoietic Cell Transplantation for CLL, 2000-2009
by Donor Type and Conditioning Regimen Intensity
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_29.ppt
Slide 31
Autologous transplant (N=253)
Myeloablative conditioning(N=425)
Reduced-intensity conditioning (N=752)
Years
0 2 61 3 4 5
Probability of Survival after Allogeneic Transplants for SAA, 2000-2009
- By Donor Type and Age -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_31.ppt
Slide 32
£ 20y, Sibling Donor (N=1,191)
> 20y, Sibling Donor (N=1,256)
£ 20y, Unrelated Donor (N=574)
> 20y, Unrelated Donor (N=550)
Years
0 2 61 3 4 5
Probability of Survival after Autologous Transplants for Hodgkin Disease, 2000-2009
- By Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_32.ppt
Slide 33
CR (N=2,419)
Not in CR, sensitive (N=2,826)
Not in CR, resistant (N=642)
Years
0 2 61 3 4 5
Probability of Survival after Allogeneic Transplants for Hodgkin Disease, 2000-2009
- By Donor Type -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_33.ppt
Slide 34
Sibling Donor (N=302)
Unrelated Donor (N=183)
Years
0 2 61 3 4 5
Probability of Survival after Autologous Transplants for Follicular Lymphoma,
2000-2009- By Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_34.ppt
Slide 35
Sensitive (N=2,030)
Resistant (N=172)
Years
0 2 61 3 4 5
Probability of Survival after HLA-identical Sibling Donor Transplants for Follicular
Lymphoma, 2000-2009- By Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_35.ppt
Slide 36
Sensitive (N=698)
Resistant (N=144)
Years
0 2 61 3 4 5
Probability of Survival after Autologous Transplants for Diffuse Large B-Cell
Lymphoma, 2000-2009- By Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_36.ppt
Slide 37
Sensitive (N=6,337)
Resistant (N=453)
Years
0 2 61 3 4 5
Probability of Survival after Allogeneic Transplants for Diffuse Large B-Cell
Lymphoma, 2000-2009- By Disease Status -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_37.ppt
Slide 38
Sensitive (N=383)
Resistant (N=124)
Years
0 2 61 3 4 5
Probability of Survival after Transplants for Mantle Cell Lymphoma,
2000-2009- By Donor Type -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_38.ppt
Slide 39
Sibling donor (N=498)
Unrelated donor (N=325)
Autologous (N=2,574)
Years
0 2 61 3 4 5
Probability of Survival after Transplants for Multiple Myeloma, 2000-2009
- By Donor Type -
0
20
40
60
80
100
10
30
50
70
90
0
20
40
60
80
100
10
30
50
70
90
Pro
babili
ty o
f Surv
ival, %
P < 0.0001
SUM-WW11_39.ppt
Slide 40
Sibling Donor (N=827)
Unrelated donor (N=470)
Autologous (N=23,197)
