Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2012 Summary Slides...
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Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2012 Summary Slides SUM12_1.ppt
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Transcript of Current Uses and Outcomes of Hematopoietic Stem Cell Transplantation 2012 Summary Slides...
Current Uses and Outcomes of Hematopoietic
Stem Cell Transplantation2012
Summary Slides
SUM12_1.ppt
Location of Centers Participating in the CIBMTR
2012
SUM12_22.ppt
Slide 2
Transp
lants
SUM12_23.ppt
Slide 3
Transplant Activity in the U.S.1980-2011
0
2000
4000
6000
8000
10000
12000
14000
Autologous
Sibling Donor HCT
Unrelated Donor HCT
SUM12_24.ppt
Allogeneic Stem Cell Sourcesby Recipient Age
2001-2010
Age £ 20 yrs Age > 20 yrs
Slide 4
Transp
lants
, %
0
20
40
60
80
100
2001-2005 2006-2010 2001-2005 2006-2010
Bone Marrow (BM)
Peripheral Blood (PB)
Cord Blood (CB)
SUM12_25.ppt
Autologous Stem Cell Sourcesby Recipient Age, 2001-2010
Age £ 20 yrs Age > 20 yrs
Slide 5
Transp
lants
, %
0
20
40
60
80
100
2001-2005 2006-2010 2001-2005 2006-2010
Bone Marrow (BM)
Peripheral Blood (PB)
BM + PB
SUM12_26.ppt
Trends in Transplantsby Type and Recipient Age*
2001-2010
* Transplants for AML, ALL, NHL, Hodgkin Disease, Multiple Myeloma Slide 6
Transp
lants
, %
Allogeneic Transplants Autologous Transplants
0
20
40
60
80
100
2001-2005 2006-2010 2001-2005 2006-2010
<=20 yrs21-40 yrs41-50 yrs51-60 yrs>60 yrs
0
20
40
60
80
100
1990-1996 1997-2003 2004-2010 1990-1996 1997-2003 2004-2010
< 50 years>= 50 years
<60 years>=60 years
SUM12_27.ppt
Trends in Transplantsby Transplant Type and Recipient Age*
1990-2010
* 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, 2010
(Inflation factor: Auto=1.25 (80%), Allo=1.05 (95%), All Transplants)
SUM12_28.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 ALL MDS/MPD HD CML AplasticAnemia
OtherLeuk
Non-Malig
Disease
OtherCancer
Allogeneic (Total N=8,860)
Autogeneic (Total N=9,026)
Indications for Hematopoietic Stem Cell Transplants for Age £ 20yrs, in the U.S., 2010
(Inflation factor: Auto=1.25 (80%), Allo=1.05 (95%), All Transplants)
SUM12_29.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=1,479)
Autologous (Total N=782)
SUM12_30.ppt
Allogeneic Transplants for Age £ 20yrs,Registered with the CIBMTR, 1993-2010
- by Donor Type and Graft Source -
Slide 10
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
1993-94 1995-96 1997-98 1999-00 2001-02 2003-04 2005-06 2007-08 2009-10
Related BM/PBUnrelated BM/PBUnrelated CB
Allogeneic Transplants for Age > 20yrs,Registered with the CIBMTR, 1993-2010
- by Donor Type and Graft Source -
Slide 11
Num
ber
of
Transp
lants
SUM12_31.ppt
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
14,000
1993-94 1995-96 1997-98 1999-00 2001-02 2003-04 2005-06 2007-08 2009-10
Related BM/PBUnrelated BMUnrelated PBUnrelated CB
Unrelated Donor Stem Cell Sourcesby Recipient Age
2001-2010
Age £ 20 yrs Age > 20 yrs
Slide 12
Transp
lants
, %
SUM12_32.ppt
0
20
40
60
80
100
2001-2005 2006-2010 2001-2005 2006-2010
Bone Marrow (BM)
Peripheral Blood (PB)
Cord Blood (CB)
Unrelated Cord Blood Transplants by AgeRegistered with the CIBMTR
2001-2010
Slide 13
Num
ber
of
Transp
lants
*
* Data incomplete
SUM12_33.ppt
0
100
200
300
400
500
600
700
800
900
1,000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
>= 16 years< 16 years
One-Y
ear
Surv
ival, %
Slide 14
One-year Survivalby Year of Transplant, Donor and Age,
Worldwide, 1997-2010- In any remission, Acute Leukemia, CML or MDS-
SUM12_34.ppt
0
20
40
60
80
100
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
HLA-matched siblings, age <50 yrsUnrelated donor, age <50 yrsHLA-matched siblings, age >=50 yrsUnrelated donor, age >=50 yrs
100-day Mortality after Autologous Transplants, 2010
Slide 15
Mort
alit
y, %
SUM12_35.ppt
0
10
20
30
40
50
Acute Leukemia Non-HodgkinLymphoma
HodgkinDisease
MultipleMyeloma
Early Disease
Intermediate/Advance Disease
SensitiveResistant
Group
0
20
40
60
80
100
AML ALL CML MDS/MPS AplasticAnemia
ImmuneDeficiency
100-day Mortality after HLA-identical Sibling Transplants,
2010
Slide 16
Early DiseaseIntermediate DiseaseAdvanced DiseaseChronic PhaseAccelerated PhaseBlast PhaseOther
Mort
alit
y, %
SUM12_36.ppt
0
20
40
60
80
100
AML ALL CML MDS/MPS AplasticAnemia
ImmuneDeficiency
100-day Mortality after Unrelated Donor Transplants,
2008-2009
Slide 17
Early DiseaseIntermediate DiseaseAdvanced DiseaseChronic PhaseAccelerated PhaseBlast PhaseOther
Mort
alit
y, %
SUM12_37.ppt
Causes of Death after Transplants
Done in2009-2010
Autologous
Infection (7%)
Other (17%)
Organ Failure (3%)
New Malignancy (1%)
Primary Disease (72%)
Unrelated Donor
Infection (18%)
Other (18%)
Organ Failure (8%)
Primary Disease(37%)
New Malignancy (1%)
GVHD (18%)
Slide 18
HLA-identical Sibling
Infection (13%)
Other (16%)
Primary Disease (49%)
GVHD (16%)
Organ Failure (5%)
New Malignancy (1%)
SUM12_38.ppt
Allogeneic TransplantsRegistered with the CIBMTR, 2001-2010
- by Conditioning Regimen Intensity & Age -
*
* Data incomplete
Slide 19
Num
ber
of
Transp
lants
SUM12_39.ppt
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
11,000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Reduced Intensity Conditioning, Age >=50 yrsReduced Intensity Conditioning, Age < 50 yrsStandard Myeloablative Conditioning
Allogeneic Transplants after Reduced-intensity Conditioning, by Donor Type,
Registered with CIBMTR 1998-2010
Slide 20
Num
ber
of
Transp
lants
SUM12_40.ppt
0
500
1,000
1,500
2,000
2,500
3,000
3,500
'98-99 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Unrelated CBUnrelated PB/BMRelated
One-Y
ear
Surv
ival, %
Slide 21
Percentage of Reduced Intensity Conditioning Allo-HCTs, Registered with CIBMTR, 1998-2010
- by Year of Transplant & Disease -
SUM12_41.ppt
0
20
40
60
80
100
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
AMLALLCLLHDMDSFollicular LYMMantle Cell LYMDeffuse Large B-cell LYM
Indications for Hematopoietic Stem Cell Transplants for Age ³ 50yrs, in the U.S., 2010
SUM12_42.ppt
Slide 22
Num
ber
of
Transp
lants
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Mye/PCD NHL AML MDS/MPS OtherLeukemia
ALL HD CML AA Oth Ca Oth Non-MalignantDisease
Allogenenic (Total N=3,029)
Autologous (Total N=5,047)
Allogeneic Transplants in the U.S.,Registered with the CIBMTR, 2007-2011
- by Donor Type -
Slide 23
Transp
lants
, %
SUM12_43.ppt
0
20
40
60
80
100
2007-2008 2009-2010
Matched related
Mismatched related
Unrelated
SUM12_44.ppt
Hematopoietic Cell Transplant Comorbid Index of U.S. Transplant Recipients
by Group Age2008-2011
Slide 24
Transp
lants
, %
0
20
40
60
80
100
Age <= 20 yrs Age 20-55 yrs Age > 55 yrs
HCT CI=0
HCT CI = 1&2
HCT CI≥ 3
Probability of Survival after HLA-identical Sibling Donor Transplants for AML, 2000-2010
- By Disease Status -
Years
0 2 61 3 4 5
Early (N=7,210)
Intermediate (N=1,906)
Advanced (N=2,923)
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, %
SUM12_2.ppt
Slide 25
P < 0.0001
Probability of Survival after Unrelated Donor Transplants for AML, 2000-2010
- By Disease Status -
Years
0 2 61 3 4 5
Early (N=5,364)
Intermediate (N=3,374)
Advanced (N=3.702)
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, %
SUM12_3.ppt
Slide 26
P < 0.0001
Survival after HLA-identical Sibling Donor Transplants for AML, Age <20 yrs, 2000-2010
- by Disease Status -
Years
0 2 61 3 4 5
Early (N=1,292)
Intermediate (N=268)
Advanced (N=270)
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, %
SUM12_4.ppt
Slide 27
P < 0.0001
Probability of Survival after Autologous Transplants for AML, 2000-2010
- by Disease Status -
Years
0 2 61 3 4 5
Early (N=2,139)
Intermediate (N=735)
Advanced (N=152)
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, %
SUM12_5.ppt
Slide 28
P < 0.0001
Probability of Survival after Allogeneic Transplants for MDS, 2000-2010- by Disease Status and Donor Type -
SUM12_6.ppt
Slide 29Years
0 2 61 3 4 50
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, %
Early, sibling donor (N=750)
Early, unrelateddonor (N=890)
Advanced, sibling donor (N=1,407)
Advanced, unrelated donor (N=1,660)
P < 0.0001
Survival after HLA-identical Sibling Donor Transplants for ALL, Age < 20 yrs, 2000-2010
- by Disease Status -
SUM12_7.ppt
Slide 30Years
0 2 61 3 4 50
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
Early (N=849)
Intermediate (N=1,203)
Advanced (N=210)
Probability of Survival after Unrelated Donor Transplants for ALL, Age < 20 yrs, 2000-2010
- By Disease Status -
SUM12_8.ppt
Slide 31Years
0 2 61 3 4 50
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
Intermediate (N=2,034)
Advanced (N=289)
Early (N=977)
Survival after HLA-identical Sibling Donor Transplants for ALL, Age ³ 20 yrs, 2000-2010
- By Disease Status -
Slide 32Years
0 2 61 3 4 50
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
Intermediate (N=715)
Advanced (N=584)
Early (N=2,214)
SUM12_9.ppt
Probability of Survival after Unrelated Donor Transplants for ALL, Age ³ 20 yrs, 2000-2010
- By Disease Status -
Slide 33Years
0 2 61 3 4 50
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
Intermediate (N=1,075)
Advanced (N=767)
Early (N=1,818)
SUM12_10.ppt
Probability of Survival after HLA-identical Sibling Donor Transplants for CML, 1998-2010
- By Disease Status and Transplant Year -
Slide 34Years
0 2 61 3 4 50
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
CP, 1998-2000 (N=2,239)
AP, 1998-2000 (N=291)
CP, 2001-2010 (N=2,498)
AP, 2001-2010 (N=360)
SUM12_11.ppt
Survival after Autologous and HLA-matched Sibling Donor Hematopoietic Cell Transplants for CLL, 2000-2010- by Donor Type and Conditioning Regimen Intensity -
Slide 35Years
0 2 61 3 4 50
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
Autologous transplant (N=270)
Myeloablative conditioning (N=450)
Reduced-intensity conditioning (N=871)
SUM12_12.ppt
Probability of Survival after Allogeneic Transplants for SAA, 2000-2010
- By Donor Type and Age -
Slide 36Years
0 2 61 3 4 50
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
£ 20y, Sibling Donor (N=1,375)
> 20y, Sibling Donor (N=1,425)
£ 20y, Unrelated Donor (N=654)
> 20y, Unrelated Donor (N=634)
SUM12_13.ppt
Probability of Survival after Autologous Transplants for Hodgkin Disease, 2000-2010
- By Disease Status -
Slide 37Years
0 2 61 3 4 50
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
CR (N=2,907)
Not in CR, sensitive (N=3,832)
Not in CR, resistant (N=1,237)
SUM12_14.ppt
Probability of Survival after Allogeneic Transplants for Hodgkin Disease, 2000-2010
- By Conditioning Regimen and Donor Type -
Slide 38Years
0 2 61 3 4 50
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 = 0.226
Sibling Donor (N=356)
Unrelated Donor (N=205)
SUM12_15.ppt
Survival after Autologous Transplants for Follicular Lymphoma, 2000-2010
- By Disease Status -
Slide 39Years
0 2 61 3 4 50
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
Sensitive (N=2,676)
Resistant (N=279)
SUM12_16.ppt
Probability of Survival after Allogeneic and HLA-identical Sibling Transplants for
Follicular Lymphoma, 2000-2010- By Disease Status -
Slide 40Years
0 2 61 3 4 50
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 = 0.002
Sensitive (N=840)
Resistant (N=212)
SUM12_17.ppt
Probability of Survival after Autologous Transplants for Diffuse Large B-Cell
Lymphoma, 2000-2010- By Disease Status -
Slide 41Years
0 2 61 3 4 50
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
Sensitive (N=8,891)
Resistant (N=1,033)
SUM12_18.ppt
Probability of Survival after HLA-identical Sibling Transplants for Diffuse Large B-Cell
Lymphoma, 2000-2010- By Disease Status -
Slide 42Years
0 2 61 3 4 50
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
Sensitive (N=503)
Resistant (N=219)
SUM12_19.ppt
Probability of Survival after Transplants for Mantle Cell Lymphoma, 2000-2010
- By Donor Type -
Slide 43Years
0 2 61 3 4 50
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
Sibling donor (N=554)
Unrelated donor (N=389)
Autologous (3,173)
SUM12_20.ppt
Probability of Survival after Transplants for Multiple Myeloma, 2000-2010
- By Donor Type -
Slide 44Years
0 2 61 3 4 50
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
Sibling Donor (N=892)
Unrelated donor (N=380)
Autologous (N27,979)
SUM12_21.ppt
