ANNUAL NUMBERS OF BLOOD AND MARROW TRANSPLANTS WORLDWIDE 1970-2002

1
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2004?10?8????
2
ANNUAL NUMBERS OF BLOOD AND MARROW TRANSPLANTS
WORLDWIDE1970-2002
Autologous
NUMBER OF TRANSPLANTS
Allogeneic
1970
1975
1980
1985
1990
1995
2000
YEAR
3
AGE OF ALLOTRANSPLANT RECIPIENTS REGISTERED WITH
THE IBMTR, 1998-2003
gt70y 60-69y 50-59y 40-49y 30-39y 20-29y lt20y
Non-Myeloablative
Traditional
4
PROBABILITY OF SURVIVAL AFTER MYELOABLATIVE
TRANSPLANTS FOR AML, 1996-2001 - By Donor Type
and Remission Status -
HLA-identical sibling, CR1 (N 3,193)
PROBABILITY,
HLA-identical sibling, CR2 (N 793)
Unrelated, CR2 (N 735)
Unrelated, CR1 (N 586)
P 0.0001
YEARS
5
PROBABILITY OF SURVIVAL AFTER MYELOABLATIVE
TRANSPLANTS FOR ALL, AGE gt20 YEARS, 1996-2001 -
By Donor Type and Remission Status -
HLA-identical sibling, CR1 (N 886)
Unrelated, CR1 (N 314)
PROBABILITY,
HLA-identical sibling, CR2 (N 336)
Unrelated, CR2 (N 264)
P 0.0001
YEARS
6
PROBABILITY OF SURVIVAL AFTER MYELOABLATIVE
TRANSPLANTS FOR CML IN CHRONIC PHASE, 1996-2001-
By Donor Type and Disease Duration -
HLA-identical sibling, lt1y (N 2,720)
HLA-identical sibling, ³1y (N 1,317)
PROBABILITY,
Unrelated, ³1y (N 951)
Unrelated, lt1y (N 677)
P 0.0001
YEARS
7
??????????????????
1975? DCMP (?? ????)
1976? DCMP 2 step (?? ???)
1980? DNRAra-C (??? ??) 1984?
1987? BHAC-DMP vs BHAC-DOMP (JALSG
AML87) 1988? ATRA???M3??? 1989? BHAC-DMP vs
DCMP (JALSG AML89) 1992? BHAC-DM vs
BHAC-EDM (JALSG AML92) 1993? 1995?
IDRAra-C (JALSG AML95)
1997? IDRAra-C (JALSG AML97)
1998? 2000? 2001? IDRAra-C vs
DNRAra-C (JALSG AML201)

????????? ?????????? ??????????? ?????????
??????????????
8
???DCMP 2 ??? (DCMP 2 step therapy)
DNR 15 25 mg/m2
Ara-C 60 100 mg/m2
6 - MP 60 100 mg/m2
PSL 15 30 mg/m2
First Step 714?
37???
Second Step 37?
Target Point NCC 15,000/µl WBC
1,200/µl 714????Target Point?????DNR?Ara-C???
1976?
9
??????????????????
1975? DCMP (?? ????)
1976? DCMP 2 step (?? ???)
1980? DNRAra-C (??? ??) 1984?
1987? BHAC-DMP vs BHAC-DOMP (JALSG
AML87) 1988? ATRA???M3??? 1989? BHAC-DMP vs
DCMP (JALSG AML89) 1992? BHAC-DM vs
BHAC-EDM (JALSG AML92) 1993? 1995?
IDRAra-C (JALSG AML95)
1997? IDRAra-C (JALSG AML97)
1998? 2000? 2001? IDRAra-C vs
DNRAra-C (JALSG AML201)

????????? ?????????? ??????????? ?????????
??????????????
10
????????????Over All Survival
65??????
46.3
33.4
Ehime Prefectural Central Hospital
1984 2000?
11
?????????????Over All Survival
34?
21.4
Ehime Prefectural Central Hospital
1984 2000?
12
??????????????????
1975? DCMP (?? ????)
1976? DCMP 2 step (?? ???)
1980? DNRAra-C (??? ??) 1984?
1987? BHAC-DMP vs BHAC-DOMP (JALSG
AML87) 1988? ATRA???M3??? 1989? BHAC-DMP vs
DCMP (JALSG AML89) 1992? BHAC-DM vs
BHAC-EDM (JALSG AML92) 1993? 1995?
IDRAra-C (JALSG AML95)
1997? IDRAra-C (JALSG AML97)
1998? 2000? 2001? IDRAra-C vs
DNRAra-C (JALSG AML201)

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13
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76 ? 84 ? 16 ? 2 ? 178 ?
82 ? 86 ? 16 ? 3 ? 187 ?
1989.42003.12
15
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Standard risk group
High risk group
P0.0789
?????
2004?3???
Ehime Prefectural Central Hospital
17
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Standard risk group
High risk group
P0.0004
?????
2004?3???
Ehime Prefectural Central Hospital
18
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Standard risk group
High risk group
P0.3553
?????
2004?3???
Ehime Prefectural Central Hospital
19
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Standard risk group
High risk group
P0.0053
?????
2004?3???
Ehime Prefectural Central Hospital
20
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Standard risk group
High risk group
P0.8863
?????
2004?3???
Ehime Prefectural Central Hospital
21
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?????
2004?3???
Ehime Prefectural Central Hospital
22
??T???????????????????
?????
2004?3???
Ehime Prefectural Central Hospital
23
?????????????????????
H15????????????????????
24
? ?
2001?10?2004?2????????????????????????????????34?
?????????????????????14?
????????(AML) 1?
(???) ??T??????(ATL) 3? (?1???
2? ??????? 1?) ????????(CML)
1? (???) ?????????(NHL) 3?
(?2??? 2? ??????? 1?) ??????? (SAA)
4? ?????????????(VAHS)
1? ?????EB???????(CAEBV) 1?
????????????
25
? ?
1759?(???35?)
???
68
H L A
DNA ?? 7?
1???? 5?
2???? 1?
3???? 1?
(???1????)
GVHD??
HLA?? (DNA??) ? Cyclosporin MTX4? 7? HLA????
FK-506 MTX3? 7?
26
?????
FludarabineBusulfan TBI
7? Fludarabine Melphalan
1? Fludarabine Melphalan TBI
1? Fludarabine Melphalan Ara-C
1? Fludarabine Cyclophosphamide
ATG 4?
Fludarabine 25mg/m2/day6??(?30mg/m2/day4??)
Busulfan 4mg/kg/day2?? T B I 2
Gy2/day1? Melphalan 70mg/m2/day2??
Ara-C 2g/m22/day2?? Cyclophosphamide
300mg/m2/day4?? A T G 10mg/kg/day4??(???
???????????) 5mg/kg/day4??(????
???????????)
27
? ?(1)
?? ?? ?? ? NCC(108/kg)
???500 ???5? ??1 ?????(STR)
1 2 3 4 5 6 7 8 9 10 11 12 13 14
SAA AML(M6) N R NHL(LBL) 2ndCR ATLL
1stCR ATL N R SAA SAA CML
AP NHL(DLBCL) 2ndCR ATL
1stCR NHL(MCL) N R SAA VAHS CAEBV
20 18 34 54 53 35 28 51 38 59 49 17 36 24
M F F F F M M F M F F M M F
3.79 3.6 2.2 4.3 2.7 1.7 3.1 2.1 2.7 2.4 3.8 2.8 3
.4 2.6
13 - 17 14 - 25 20 18 15 17 14 16 21 16
22 - 28 19 - - 26 36 16 28 - 28 41 -
15 - 24 24 - - 33 25 - 20 26 19 26 26
Donor - Donor Donor - Recipient(??) Donor Donor Do
nor Donor - Donor(????) - Donor
28
? ?(2)
?? ?? ?? ? ??GVHD
???day ??GVHD ?? ??
1 2 3 4 5 6 7 8 9 10 11 12 13 14
SAA AML(M6) N R NHL(LBL) 2ndCR ATLL
1stCR ATL N R SAA SAA CML
AP NHL(DLBCL) 2ndCR ATL
1stCR NHL(MCL) N R SAA VAHS CAEBV
20 18 34 54 53 35 28 51 38 59 49 17 36 24
M F F F F M M F M F F M M F
? / ? ? / / 0 ? ? ? ? 0 ? ?
23 / 61 33 / / / 15 50 24 12 / 45 18
Limited / Limited No / / No Extensive Limited No /
No / Limited
No / Yes No No / No Yes No No No / No No
?? ?? ?? ?? ?? ?? ?? ?? ?? ?? ?? ?? ?? ??
29
?????????????????????????14?????
56.3
?????
30
?????????????????
????
????(allo-BMT) ????????(allo-PBSCT) ?????(allo-
CBCT)
Standard Risk
High Risk
?
Donor ??
????
????????( auto-PBSCT)
Standard Risk
AML 1st and 2nd CR, ALL 1stCR , CML CP
High Risk
????
Division of Hematology Ehime Prefectural Central
Hospital
31
??????????
AML
JALSG ?????? JSCT ??????
????
?1???
??(?????????)?????(M3???)
?2?????????
??(?????????)?????
????
??(?????????)????????
32
??????????
ALL
JALSG ??????
????
?1???
??(?????????)????????
?2?????????
??(?????????)????????
????
??(?????????)????????
33
??????????
CML
Imatinib 400mg/day po
????
???
??(?????????)?????
???
??(?????????)????????
?????
??(?????????)????????
34
???????????????????
??
2004?
Imatinib ??
HLA?????()
HLA?????(-)
HLA????? ???????
?????????CCR (12??)
CCR????? (12??)
?????????CCR (12??)
CCR????? (12??)
HLA???????????
??
??
?????????CCR
????????? ????CCR?????
?????????CCR
????????? ????CCR?????
??
??
Division of Hematology Ehime Prefectural Central
Hospital
35
???????????????????
????? ???? HLAA,B,DR????????
NMDP (USA) ZKRD (Germany) Anthony Nolan Trust
(UK) Italian BMDR (Italy) T.C.TMDR (Taiwan
R.O.C) CBSBMDR (Canada) JMDP (Japan) BBMR
(UK) Australian BMDR including the New Zealand
BMDR
3,635,109 1,880,458 331,681 293,637 224,305 221,86
2 161,448 159,221 158,913
2,677,186 (74) 744,106 (40) 233,187
(70) 140,404 (48) 167,530 (75) 82,712
(37) 160,170 (99) 131,215 (82) 91,336 (57)
BMDW 2002.12
36
???????(???)????????( ??)
?
2003?12??? 180,720?
37
??????????????
lt??gt
50???(51???????????????)
lt??gt
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??????
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lt???gt
HLA??????????????
2001?1???
38
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39
?????????????????(??)
2003?12??? 5,305?
?
40
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HLA A?B?DR
HLA
A?B?DR
?????? ???
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HLA
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A?B?DR??
A?B?DR??
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JMDP ??16?3???
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325527
479744
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2003?JMDP
43
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2003?JMDP
44
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2003?JMDP
45
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2004?7???193,050?
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