Hematopoietic Stem Cell Transplantation in the Eastern Mediterranean Region (EMRO) 2008-2009: Report on behalf of the Eastern Mediterranean Bone Marrow Transplantation (EMBMT) Group

Said Yousef Ahmed Mohamed, Ibtihal Fadhil, Rose Marie Hamladji, Amir Ali Hamidieh, Omar Fahmy, Saloua Ladeb, Kamran Alimoghaddam, Alaa Elhaddad, Redhouane Ahmed Nacer, Fahad Alsharif, Walid Rasheed, Mohammad Jahani, Seyed Asadollah Mousavi, Amal Alseraihy, Fawzi Abdel-Rahman, Abdullah Al Jefri, Ayad Ahmed Hussein, Abdulaziz Alabdulaaly, Ahmad Ibrahim, Mohamed Amine BekadjaMiguel Abboud, Parvez Ahmed, David Dennison, Mohammad Bakr, Said Benchekroun, Fazal Hussain, Tarek Ben Othman, Mahmoud Aljurf, Ardeshir Ghavamzadeh

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background: The Eastern Mediterranean Bone Marrow Transplantation (EMBMT) Group has accumulated over 25 years of data and experience in hematopoietic stem cell transplantation (HSCT), most particularly in hem-moglobinopathies, severe aplastic anemia (SAA), and inherited metabolic and immune disorders, in addition to hematologic malignancies peculiar to the region and where recent updates in trends in activities are warranted. Objectives: To study trends in HSCT activities in the World Health Organization-Eastern Mediterranean (EM) region surveyed by EMBMT between 2008 and 2009. STUDY DESIGN: Retrospective analysis of the survey data, mainly of the cumulative number of transplants, types of transplants (autologous vs. allogeneic), types of conditioning as myeloablative (MAC) vs. reduced intensity conditioning (RIC) and trends in leukemias, hemog-globinopathies, SAA, inherited bone marrow failure syndromes amongst others. Results And Discussion: Fourteen teams from ten Eastern Mediterranean Region Organization (EMRO) countries reported their data (100% return rate) to the EMBMT for the years 2008-2009 with a total of 2608 first HSCT (1286 in 2008; 1322 in 2009). Allogeneic HSCT represented the majority (63%) in both years. The main indications for allogeneic HSCT were acute leukemias (732; 44%), bone marrow failure syndromes (331, 20%), hemoglobinopathies (255; 15%) and immune deficiencies (90; 5%). There was a progressive increase in the proportions of chronic myeloid leukemia (CML) cases transplanted beyond the first chronic phase (3; 7% of all CML cases in 2008 vs 13; 29% in 2009). The main indications for autologous transplants were plasma cell disorders (345; 36%) Hodgkin disease (256; 27%), non-Hodgkin lymphoma (207; 22%) and solid tumors (83; 9%). RIC continued to show a progressive increase over the years (7% in 2007, 11% in 2008 and 13% in 2009), yet remained relatively low compared to contemporary practices in Europe published by EBMT. The vast majori-ity (95%) of allo-HSCT sources were from sibling donors with a continued dominance of peripheral blood (PB) (1076; 63%), while cord blood transplant (CBT) increased to 83 (5% of allo-HSCT), matched unrelated donor (MUD) remained underutilized (1; 0%) and there were no haploidentical transplants reported. Large centers with >50 HSCT/year showed a plateau of the total number of allo-HSCT over the last 5 years that may be related to capacity issues and needs further study. Conclusions And Recommendations: There is an overall increased rate of HSCT in the EMRO region with a significant increase in utilization of CBT and allogeneic PB-HSCT as a valuable source. However, further research on outcome data and development of regional donor banks (CB and MUD) may help facilitate future planning to satisfy the regional needs and increase collaboration within the group and globally.

Original languageEnglish
Pages (from-to)81-93
Number of pages13
JournalHematology/ Oncology and Stem Cell Therapy
Volume4
Issue number2
DOIs
Publication statusPublished - 2011

ASJC Scopus subject areas

  • Hematology
  • Oncology

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