The EBMT activity survey 2008: impact of team size, team density and new trends

Six hundred and fifteen centers from 45 countries reported a total 30 293 HSCT to this 2008 EBMT survey with 26 810 first transplants (40% allogeneic, 60% autologous). This corresponds to an increase of 7% for the allogeneic and 3% for the autologous HSCT. Main indications were leukemias (32%; 89% allogeneic); lymphomas (56%; 89% autologous); solid tumors (6%; 96% autologous); and non-malignant disorders (6%; 88% allogeneic). There were more unrelated than HLA-identical sibling donors (49 vs 46%). The proportion of peripheral blood transplants remained stable with 99% for autologous and 70% for allogeneic HSCT. One fifth of the teams with >80 HSCT performed more than half of all HSCT. This trend towards teams with higher numbers of HSCT was stronger for allogeneic (Gini coefficient 57%) than for autologous HSCT (Gini coefficient 38%). Transplant rates (number of transplants per 10 million inhabitants) increased in a close to linear way with increasing team density (number of transplant teams per 10 million inhabitants) and without saturation (R-2 = 0.54); this connection was even stronger for allogeneic HSCT (R-2 = 0.67). These data illustrate status and trends for HSCT in Europe. They provide a rational basis for planning and patient counseling. Bone Marrow Transplantation (2011) 46, 174-191; doi: 10.1038/bmt.2010.69; published online 29 March 2010