Global Trends in Hematopoietic Cell Transplantation Use in Multiple Myeloma

A global study presented at the 2019 ASH Annual Meeting observed an increased trend in autologous hematopoietic cell transplantation (AHCT) among patients with multiple myeloma (MM), as well as a decline in allogeneic HCT (alloHCT).

Researchers assessed a retrospective survey of the Worldwide Network of Blood and Marrow Transplantation, which was conducted annually between 2006 and 2015 and included data on 68,146 HCTs (53% autologous and 47% allogeneic) from 77 countries. Incidence data estimates were reported from the Global Burden of Disease study. Outcome measures included total number of autologous and allogeneic HCTs by World Bank regions.

Between 2006 and 2015, there was a 107% worldwide increase in AHCTs performed for MM, with increases ranging from 56% in the United States to 335% in Latin America. AHCT use was highest in Northern American (increase from 13% to 24%) and European (increase from 15% to 22%) regions. Meanwhile, utilization reached more than 10% in Latin America.

However, utilization of AHCT was much lower in the Africa/Mediterranean and Asian/Pacific regions, with AHCT utilization increasing slightly from 1.8% to 4.0%. Thus, there are marked disparities in high versus low- to middle-income countries, the authors noted.

The number of first alloHCTs performed globally for MM peaked in 2012 and declined by –3% since 2006, mostly in North America. AlloHCT use remains highest in the European region (increase of 8%).

Conflicting clinical trial data likely contributed to the decline in some regions for first alloHCT in MM, according to the authors, who said more work is needed to improve access to transplantation services for MM patients, especially in low- to middle-income countries.

Reference

Cowan AJ, Baldomero H, Atsuta Y, et al. The global state of hematopoietic stem cell transplantation for multiple myeloma: an analysis of the Worldwide Network of Blood and Marrow Transplantation (WBMT) database and the Global Burden of Disease Study. Abstract 412. Presented at the 2019 ASH Annual Meeting, December 8, 2019; Orlando, Florida.