title: Hematopoietic stem cell transplantation in the Eastern Mediterranean Region (EMRO) 2008-2009: report on behalf of the Eastern Mediterranean Bone Marrow Transplantation (EMBMT) Group.
abstract: BACKGROUND
  The Eastern Mediterranean Bone Marrow Transplantation (EMBMT) Group has accumulated over 25 years of data and experience in hematopoietic stem cell transplantation (HSCT), most particularly in hemoglobinopathies, severe aplastic anemia (SAA), and inherited metabolic and immune disorders, in addition to hematologic malignancies peculiar to the region and where recent updates in trends in activities are warranted.
  
  
  OBJECTIVE
  To study trends in HSCT activities in the World Health Organization-Eastern Mediterranean (EM) region surveyed by EMBMT between 2008 and 2009.
  
  
  METHODS
  Retrospective analysis of the survey data, mainly of the cumulative number of transplants, types of transplants (autologous vs. allogeneic), types of conditioning as myeloablative (MAC) vs. reduced intensity conditioning (RIC) and trends in leukemias, hemoglobinopathies, SAA, inherited bone marrow failure syndromes amongst others.
  
  
  CONCLUSIONS
  Fourteen teams from ten Eastern Mediterranean Region Organization (EMRO) countries reported their data (100% return rate) to the EMBMT for the years 2008-2009 with a total of 2608 first HSCT (1286 in 2008; 1322 in 2009). Allogeneic HSCT represented the majority (63%) in both years. The main indications for allogeneic HSCT were acute leukemias (732; 44%), bone marrow failure syndromes (331, 20%), hemoglobinopathies (255; 15%) and immune deficiencies (90; 5%). There was a progressive increase in the proportions of chronic myeloid leukemia (CML) cases transplanted beyond the first chronic phase (3; 7% of all CML cases in 2008 vs 13; 29% in 2009). The main indications for autologous transplants were plasma cell disorders (345; 36%) Hodgkin disease (256; 27%), non-Hodgkin lymphoma (207; 22%) and solid tumors (83; 9%). RIC continued to show a progressive increase over the years (7% in 2007, 11% in 2008 and 13% in 2009), yet remained relatively low compared to contemporary practices in Europe published by EBMT. The vast majority (95%) of allo-HSCT sources were from sibling donors with a continued dominance of peripheral blood (PB) (1076; 63%), while cord blood transplant (CBT) increased to 83 (5% of allo-HSCT), matched unrelated donor (MUD) remained underutilized (1; 0%) and there were no haploidentical transplants reported. Large centers with >50 HSCT/year showed a plateau of the total number of allo-HSCT over the last 5 years that may be related to capacity issues and needs further study.
  
  
  CONCLUSIONS
  There is an overall increased rate of HSCT in the EMRO region with a significant increase in utilization of CBT and allogeneic PB-HSCT as a valuable source. However, further research on outcome data and development of regional donor banks (CB and MUD) may help facilitate future planning to satisfy the regional needs and increase collaboration within the group and globally.
authors: King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. saidyousuf@kfshrc.edu.sa
authors: Said Yousef Ahmed
authors: SY
authors: Mohamed
authors: Ibtihal
authors: I
authors: Fadhil
authors: Rose-Marie
authors: RM
authors: Hamladji
authors: Amir Ali
authors: AA
authors: Hamidieh
authors: Omar
authors: O
authors: Fahmy
authors: Saloua
authors: S
authors: Ladeb
authors: Kamran
authors: K
authors: Alimoghaddam
authors: Alaa
authors: A
authors: Elhaddad
authors: Redhouane Ahmed
authors: RA
authors: Nacer
authors: Fahad
authors: F
authors: Alsharif
authors: Walid
authors: W
authors: Rasheed
authors: Mohammad
authors: M
authors: Jahani
authors: Seyed Asadollah
authors: SA
authors: Mousavi
authors: Amal
authors: A
authors: Alseraihy
authors: Fawzi
authors: F
authors: Abdel-Rahman
authors: Abdullah
authors: A
authors: Al Jefri
authors: Ayad Ahmed
authors: AA
authors: Hussein
authors: Abdulaziz
authors: A
authors: Alabdulaaly
authors: Ahmad
authors: A
authors: Ibrahim
authors: Mohamed-Amine
authors: MA
authors: Bekadja
authors: Miguel
authors: M
authors: Abboud
authors: Parvez
authors: P
authors: Ahmed
authors: David
authors: D
authors: Dennison
authors: Mohammad
authors: M
authors: Bakr
authors: Said
authors: S
authors: Benchekroun
authors: Fazal
authors: F
authors: Hussain
authors: Tarek Ben
authors: TB
authors: Othman
authors: Mahmoud
authors: M
authors: Aljurf
authors: Ardeshir
authors: A
authors: Ghavamzadeh
mesh_terms: D000208:Acute Disease; D000741:Anemia, Aplastic; D001855:Bone Marrow Diseases; D000080983:Bone Marrow Failure Disorders; D036101:Cord Blood Stem Cell Transplantation / Q000706:statistics & numerical data; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data*; D006453:Hemoglobinopathies / Q000628:therapy; D006457:Hemoglobinuria, Paroxysmal / Q000628:therapy; D006801:Humans; D007154:Immune System Diseases / Q000628:therapy; D007938:Leukemia / Q000628:therapy; D019083:Mediterranean Region; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000706:statistics & numerical data