Haematopoietic stem cell transplantation (HSCT), or bone marrow transplantation, reached its record number in Spain in 2023, with 3,717 procedures, representing a rate of 77.4 transplants per million population (pmp).
These data are taken from the report on HSCT just published by the National Transplant Organisation (ONT). Of the HSCT performed last year, 2,253 (61%) were carried out with the patient's own cells (autologous transplants) and 1,464 (39%) with cells from a donor (allogeneic transplants), 832 of whom were related to the patient and 632 of whom were unrelated volunteer donors.
This is the first time that more than 600 unrelated donor HSCTs have been performed in a year in Spain.
Increased activity of allogeneic HSCT
TPH activity has been increasing in our country for more than a decade. In particular, allogeneic HSCT has increased by 46% since 2012 (related donor by 54% and unrelated donor by 37%). To this effect, Spain exceeded 30 allogeneic HSCT pmp for the first time in 2023, as one of the European countries with the highest activity in this type of transplantation.
This success is part of the National Bone Marrow Plan (PNMO), which pools the efforts of the ONT, the autonomous communities, scientific societies, patient associations and the José Carreras International Foundation, which manages the Spanish Bone Marrow Donor Registry (REDMO), following the signing of the Framework Agreement between this entity, the Ministry of Health and the ONT.
By autonomous community, the highest level of PHCT activity last year was recorded in Madrid, with 701 transplants, followed by Catalonia (635) and Andalusia (592). In pmp rates, the highest TPH activity was recorded in Navarra (150.7), Cantabria (112.1) and Madrid (102.3).
In terms of indications for HSCT, of the 3,717 performed in 2023, 2,244 (60%) were for the treatment of lymphoproliferative diseases, 1,208 (33%) for leukaemias, 147 (4%) for solid tumours, 99 (3%) for non-malignant diseases and 19 (<1%) for other diseases. A total of 275 (7%) PHCTs were performed in children.
Steady growth of REDMO
The performance of unrelated donor HSCT relies on the voluntary donation of individuals registered in the World Registry of Bone Marrow Donors (WMDA), which pools the data of 42 million donors worldwide and has more than 800,000 stored cord blood units (SCU). The WMDA is composed of 103 donor registries from 56 countries, including Spain through REDMO.
In 2023, 23,686 new donors joined REDMO, an 8% increase on 2022. As of 1 June 2024, REDMO had 492,958 donors, compared to 100,000 donors registered in 2012, when PNMO was launched. The rate of persons registered in REDMO is 10,083 pmp. Navarra (19,022), Murcia (16,800) and Extremadura (15,651) are the autonomous communities with the highest pmp rates of donors registered.
The average age of donors in REDMO is 32 years. Half the registered donors (51%) are under 40 years of age. In terms of the sex of donors, the majority are female, accounting for 64% of the register.
The need for more male donors is evident, however, in requests from transplant centres, as these donors increase the effectiveness of transplantation.
Thanks to the rejuvenation of REDMO and the improved characterisation of voluntary donors (HLA typing) that characterises the PNMO, there were 396 effective donations in 2023, a growth of 24% compared to 2022 and 1000% compared to 2012. The effective donation rate thereby stands at 8/10,000, exceeding the target set by PNMO.
Umbilical cord blood units
Spain has 62,097 umbilical cord blood units (SCU), 7.4% of those stored in the world (831,000). As such it has the largest pool of units in Europe and the second largest in the world, behind only the US.
In 2023, 81 SCU units in Spain were used to perform HSCT, 7 for national patients and 74 for foreign patients. The 14 SCU transplants performed in Spain in 2023 used SCU units from public banks.
To facilitate the use of SCU units stored in Spain, the ONT launched the 'Ready to Ship' (R2S) project, funded by the Ministry of Health. The project consists of the detailed characterisation of high quality SCU units to respond to patients in urgent need of HSCT. Thanks to this initiative, the release of SCU units for transplantation increased by 73% during the first four months of this year compared to the same period last year.
Non official translation
Organ donation
