Berlin More than one million people have received blood and marrow stem cells transplants since the first procedure in 1957, according to a new research. However, there are still too many patients who are unable to find a suitable donor and at any time around over 37,000 people are waiting worldwide for a blood stem cell donation, researchers said.
The research also found striking variations between countries and regions in the use of this lifesaving procedure and high unmet need due to a chronic shortage of resources and donors that is putting lives at risk. Hematopoietic stem cell transplantations (HSCT), also known as blood and marrow transplant, is most often used to treat diseases of the blood and several types of cancer such as multiple myeloma or leukaemia.
The procedure provides healthy cells from either the patient (autologous transplantation) or from a healthy donor (allogeneic transplantation) to replace those lost to disease or chemotherapy. Using data collected by the Worldwide Network for Blood and Marrow Transplantation (WBMT), Professor Dietger Niederwieser from the University Hospital Leipzig in Germany and international colleagues, systematically analysed the growth of HSCT and changes in its use in 194 WHO member countries since the first transplant in 1957.
They also examined the link between macroeconomic factors (eg, gross national income and health care expenditure) and transplant frequencies per 10 million inhabitants in each country. Although only a small number of centres had performed about 10,000 transplants by 1985, this had risen to around 500,000 ten years later, and doubled to more than 1 million transplants done at 1,516 transplant centres across 75 countries by the end of December 2012.
The study found that transplants are more common in countries with greater financial resources and more institutions with the resources and expertise to perform HSCT. Most of the HSCTs have been performed in Europe (53 per cent), followed by the Americas (31 per cent), South East Asia and Western Pacific (15 per cent), and the Eastern Mediterranean and Africa (2 per cent).
Numbers of donor transplants have rapidly expanded in all regions without any signs of saturation. This is likely to reflect substantial underuse of this therapy, said the authors, suggesting that more patients would have been treated with allogeneic transplantation had it been accessible, or had suitable donors been available.
The international exchange of stem-cell products also increased to more than 10,000 a year between 2006 and 2012, with substantial differences between countries in the amount of stem cells they import or export. Despite these increases there are still too many patients who are unable to find a suitable donor. At any time around 1,800 people in the UK are waiting for a blood stem cell donation, and over 37,000 people are waiting worldwide. The study is published in The Lancet Haematology journal.