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The 2007 report describes the current status of HSCT activity in Europe, highlights the increasing role of allogeneic HSCT in treatment of AML and gives the first quantitative information on novel cellular therapies. In 2007, there were 25 563 first HSCTs, 10 072 allogeneic (39%), 15 491 autologous (61%) and 3606 additional transplants reported from 613 centers in 42 countries. The main indications were leukemias (8061 (32%; 89% allogeneic)); lymphomas (14 627 (57%; 89% autologous)), solid tumors (1488 (6%; 96% autologous)) and nonmalignant disorders (1302 (5%; 91% allogeneic)). Peripheral blood was the main source of stem cells for autologous HSCT (98%) and the predominant source for allogeneic HSCT (71%). Among allogeneic HSCTs, the number of unrelated donor grafts equaled the number of HLA-identical sibling donor grafts for the first time (47% each). AML was the most frequent indication for allogeneic HSCT (32% of all allogeneic HSCTs), with an increase of 247 (8%). Information on novel cellular therapies was collected for the first time; there were 212 mesenchymal SCTs and 212 HSCTs for nonhematopoietic use. The indications for the latter were cardiovascular disorders (97; 46%), neurological disorders (94; 44%) and tissue repair (21; 10%). These data illustrate the expanding role of cellular therapies.

Background Parathyroid cryopreservation is often utilized for patients having parathyroidectomy. This allows for future autotransplantation if a patient becomes permanently hypocalcemic after surgery. However, the practice of cryopreservation is costly and time-consuming, while the success rate of delayed autotransplantation is highly variable. We sought to determine the rate and outcomes of parathyroid cryopreservation and delayed autotransplantation at our institution to further evaluate its utility. Methods At our institution, 2,083 parathyroidectomies for hyperparathyroidism (HPT) were performed from 2001 to 2010. Of these, parathyroid cryopreservation was utilized in 442 patients (21 %). Patient demographics, preoperative diagnoses, and other characteristics were analyzed, as well as the rate and success of delayed autotransplantation. Results Of the 442 patients with cryopreservation, the mean age was 55 ± 1 years and 313 (70.8 %) were female. A total of 308 (70 %) had primary HPT, 46 (10 %) had secondary HPT, and 88 (20 %) had tertiary HPT. Delayed autotransplantation of cryopreserved parathyroid tissue was used in 4 (1 %) patients at an average time of 9 ± 4 months after initial surgery. Three of the 4 patients remained hypoparathyroid after this procedure. The single cured patient underwent the procedure only 4 days after the initial parathyroidectomy. Conclusions Although cryopreservation was used in over one-fifth of patients undergoing parathyroidectomy, the need for parathyroid reimplantation was very low (1 %). Furthermore, the success rate of parathyroid autotransplantation was poor in these patients. Therefore, the continued practice of parathyroid cryopreservation is questionable.

This report describes the hematopoietic stem cell transplantation (HSCT) activity in Europe in 2006 by indication, donor type and stem cell source. It illustrates differences compared to previous years and concentrates on the use of cord blood transplants. In 2006, there were 25 050 first HSCT, 9661 allogeneic (39%), 15 389 autologous (61%) and 3690 additional re- or multiple transplants reported from 605 centers in 43 participating countries. Main indications were leukemias (7963 (32%; 85% allogeneic)); lymphomas (14 169 (56%; 89% autologous)); solid tumors (1564 (6%; 95% autologous)); non-malignant disorders (1242 (5%; 90% allogeneic)) and non-classified ‘others’ (112 (1%)). There was an increase in allogeneic HSCT of 9% when compared to 2005, while autologous HSCT numbers remained similar. There were 544 allogeneic cord blood HSCT, which corresponds to 5% of all allogeneic HSCT. The majority, 67%, were used for patients with leukemia. The highest percentage of cord blood transplants, 27%, was seen for inherited disorders of metabolism. No autologous cord blood transplants were reported. The highest increase in allogeneic HSCT was observed for AML, which comprises 31% of all allogeneic HSCT. Numbers of autologous HSCT remained similar in most main indications. This data provide an update of the current HSCT experience in Europe.

This survey on transplantation of hematopoietic stem cells from blood or bone marrow in Europe, the 10th in a series, reports the numbers of transplants performed in 1999 and concentrates on changes in indications and donor types. Members of the European Group for Blood and Marrow Transplantation and associated teams are invited every year to report their transplant numbers by indication, donor type and stem cell source. In 1999, a total 21 430 transplants were performed by 580 teams in 35 European countries. Of these transplants 18 720 were first transplants, 5879 (31%) allogeneic, 12 841 (69%) autologous; an additional 562 allogeneic and 2148 autologous transplants were re- or multiple transplants. Ninety-five percent of the autologous transplants and 45% of the allogeneic transplants were peripheral blood stem cell transplants. A total of 103, respectively 1.8% of the allogeneic transplants, were cord blood cell transplants. Main indications in 1999 were leukemias with 6289 transplants (34%), 70% thereof allogeneic transplants; lymphomas with 8219 transplants (44%), 92% thereof autologous transplants; solid tumors with 3302 transplants (18%), 99% thereof autologous transplants; nonmalignant disorders with 715 transplants (4%), 85% thereof allogeneic transplants. Absolute numbers of allogeneic transplants continued to increase as in previous years by 10%, in contrast, there was for the first time in 10 years a decrease in autologous transplants, mainly for solid tumors. Reasons therefore are discussed. These data reflect the most recent changes in utilisation and document current status of blood and marrow transplantation in Europe.

Purpose To evaluate the effect of a preoperative protocol that triages patients awaiting total joint arthroplasty to one of four strategies designed to mitigate the risk of allogeneic blood transfusion (ABT) based on a priori transfusion risk on perioperative exposure to allogeneic blood. Methods We compared the transfusion experiences of a historical control series of 160 subjects with a study group of 160 subjects treated by protocol. Protocol subjects with hemoglobin (Hb) 100-129 g·L −1 were given erythropoietin, dosed by weight. Subjects with Hb 130-139 g·L −1 underwent preoperative autologous blood harvest and perioperative re-infusion as deemed clinically necessary. Subjects with Hb >139 g·L −1 received no special intervention, unless they were aged >70 yr and weighed < 70 kg, in which case they received oral iron and folate supplementation. Results The relative risk of ABT in the Study group was 0.68 (95% confidence interval 0.54-0.85). The Control group received 104 units of allogeneic blood and the Study group received 35 units ( P  = 0.0007). These differences cannot be explained by differences in transfusion risk or autologous units transfused. There was no worsening of anemia or its consequences in the Study group. Conclusion A simple protocol based on easily obtained preoperative clinical indices effectively targets interventions that mitigate the risk of ABT.

A record number of 40 829 hematopoietic stem cell transplantation (HSCT) in 36 469 patients (15 765 allogeneic (43%), 20 704 autologous (57%)) were reported by 656 centers in 47 countries to the 2014 survey. Trends include: continued growth in transplant activity, more so in Eastern European countries than in the west; a continued increase in the use of haploidentical family donors (by 25%) and slower growth for unrelated donor HSCT. The use of cord blood as a stem cell source has decreased again in 2014. Main indications for HSCT were leukemias: 11 853 (33%; 96% allogeneic); lymphoid neoplasias; 20 802 (57%; 11% allogeneic); solid tumors; 1458 (4%; 3% allogeneic) and non-malignant disorders; 2203 (6%; 88% allogeneic). Changes in transplant activity include more allogeneic HSCT for AML in CR1, myeloproliferative neoplasm (MPN) and aplastic anemia and decreasing use in CLL; and more autologous HSCT for plasma cell disorders and in particular for amyloidosis. In addition, data on numbers of teams doing alternative donor transplants, allogeneic after autologous HSCT, autologous cord blood transplants are presented.

Improvements in acute burn care have enabled patients to survive massive burns that would have once been fatal. Now up to 70% of patients develop hypertrophic scars after burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. Approaches to optimise healing potential of burn wounds use targeted wound care and surgery to minimise the development of hypertrophic scarring. Such approaches often fail, and modulation of the established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventive and therapeutic strategies.

The new coronavirus SARS-CoV-2 has rapidly spread over the world causing the disease by WHO called COVID-19. This pandemic poses unprecedented stress on the health care system including programs performing allogeneic and autologous hematopoietic cell transplantation (HCT) and cellular therapy such as with CAR T cells. Risk factors for severe disease include age and predisposing conditions such as cancer. The true impact on stem cell transplant and CAR T-cell recipients in unknown. The European Society for Blood and Marrow Transplantation (EBMT) has therefore developed recommendations for transplant programs and physicians caring for these patients. These guidelines were developed by experts from the Infectious Diseases Working Party and have been endorsed by EBMT’s scientific council and board. This work intends to provide guidelines for transplant centers, management of transplant candidates and recipients, and donor issues until the COVID-19 pandemic has passed.

Autologous stem cell transplantation is a standard treatment strategy for patients with multiple myeloma that requires effective mobilization and apheresis of peripheral blood progenitor cells; however, in the current era of novel myeloma induction therapies, the optimal mobilization regimen to enhance stem cell yield while limiting toxicity and resource utilization remains unknown. In this multicenter retrospective study, we assessed apheresis and transplant outcomes in myeloma patients mobilized with granulocyte colony stimulating factor (G-CSF) alone (n = 62), G-CSF with chemotherapy (n = 43), or G-CSF with the CXCR4 antagonist plerixafor (n = 417). Compared to patients treated with G-CSF alone, the plerixafor group required significantly fewer median apheresis sessions (1 vs 2, p = 0.0023) with higher CD34+ stem cell yield (9.9 vs 5.8 × 106 cells/kg, p < 0.001) and had significantly faster engraftment of neutrophils (HR 1.54, 95% CI 1.17–2.03) and platelets (HR 2.24, 95% CI 1.69–2.96) after transplant. Additionally, the plerixafor group showed a significantly better toxicity profile and lower adverse event rate than patients treated with G-CSF alone (p = 0.0028) or chemomobilization (p < 0.0001), with a trend toward reduced survival in chemomobilization patients. Taken together, these data support the routine use of plerixafor-based mobilization to increase apheresis efficiency and reduce toxicity in myeloma patients undergoing transplant.

In patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) who are either refractory to first-line therapy or relapse within 12 months, chimeric antigen receptor (CAR) T-cell therapy is more effective than salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) as second-line therapy. Adoption of CAR T-cell therapy into routine clinical practice involves a period of adaptation and refinement of clinical processes. We aimed to document the evolution of clinical processes for CAR T-cell therapy during 2022 and 2023, and compare healthcare resource utilization (HCRU) associated with CAR T-cell and ASCT processes in routine clinical practice. ClipMed PPM software-based process modeling was used to assess HCRU for patients with R/R LBCL receiving CAR T-cell or ASCT therapy, mapping 991 and 1174 processes associated with CAR T-cell therapy in 2023 and 2022, respectively, and 1874 processes associated with ASCT over both years. Improvements in lymphodepletion therapy administration and assessment and management of CAR T-cell therapy-specific adverse events led to a 5-day (30%) reduction in hospitalization and a 15% decrease in total personnel time in the CAR T-cell therapy process from 2022 to 2023. HCRU for CAR T-cell therapy was almost half that of ASCT, with 77% less personnel time for therapy administration. Hospitalization for CAR T-cell therapy was 70%-75% shorter than for ASCT therapy (11–13 vs. 44 days). These patient-centered process efficiencies provide patients with reduced hospitalization time. Understanding this evolution is vital for addressing complexities of advanced treatments, enhancing patient care quality, and optimizing resource allocation.