Lifetime probabilities of hematopoietic stem cell transplantation in the US
Lifetime probabilities of hematopoietic stem cell transplantation in the US
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DOI：
10.1016/j.bbmt.2007.12.493
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发表时间：
2008-03-01
影响因子：
4.3
通讯作者：
Horowitz, Mary M.
中科院分区：
文献类型：
--
作者：
Nietfeld, J. J.;Pasquini, Marcelo C.;Horowitz, Mary M.
关于造血干细胞移植（HSCT）的医疗保健政策必须解决程序的需要以及干细胞来源的可用性：骨髓，外周血或脐带血（UCB）。然而，关于接受HSCT的终生概率的数据缺乏。这项研究是为了估计美国的后一种概率，取决于年龄性别和种族我们使用了来自国际血液和骨髓移植研究中心，美国监测，流行病学和最终结果计划以及美国人口普查局的数据，并计算了累积发病率的概率。考虑了几种情况：假设目前自体和同种异体HSCT的适应症，假设普遍的供体可用性，并假设HSCT在血液恶性肿瘤中的使用扩大。用HSCT治疗的疾病和HSCT的发生率随着年龄的增长而增加，40岁后强烈上升。在40岁以上的人群中，男性的发病率高于女性。在各种情况下，接受HSCT的终身概率范围为0.23%至0.98%。我们的结论是，考虑到目前的适应症，接受自体或异体HSCT的终生概率远高于以前报道的其他人，并可能上升甚至更高，随着供体的可用性和HSCT的适用性。(C)2008年美国血液和骨髓移植协会。
Healthcare policies regarding hematopoietic stem cell transplantation (HSCT) must address the need for the procedure as well as the availability of stem cell sources: bone marrow, peripheral blood, or umbilical cord blood (UCB). However, data with respect to the lifetime probability of undergoing HSCT are lacking. This study was undertaken to estimate the latter probability in the United States (U.S.), depending on age, sex, and race. We used data from the Center for International Blood and Marrow Transplant Research, the U.S. Surveillance, Epidemiology and End Results Program, and the U.S. Census Bureau and calculated probabilities as cumulative incidences. Several scenarios were considered: assuming current indications for autologous and allogeneic HSCT, assuming universal donor availability, and assuming broadening of HSCT use in hematologic malignancies. Incidences of diseases treated with HSCT and of HSCTs performed increase with age, rising strongly after age 40. Among individuals older than 40, incidences are higher for men than for women. The lifetime probabilities of undergoing HSCT range from 0.23% to 0.98% under the various scenarios. We conclude that, given current indications, the lifetime probability of undergoing autologous or allogeneic HSCT is much higher than previously reported by others and could rise even higher with increases in donor availability and HSCT applicability. (C) 2008 American Society for Blood and Marrow Transplantation.