Survival after hematopoietic cell transplantation in children and adults in four decades of experience: nationwide study

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Objective The objective of this study was to provide a comprehensive nationwide analysis of the development of hematopoietic cell transplantation (HCT) in Poland in the years 1984-2024, including temporal trends in transplant activity, transplant and donor types, stem cell sources, and patient survival. Methods Centers reported basic data on all HCTs performed from the beginning of their activity up to the end of 2024. Survival data were identified in national registry. Results The total number of HCTs was 30,812, including 40.1% allo-HCTs and 59.9% auto-HCTs. Pediatric centers performed 22.8% of all transplants; including 5.8% all auto-HCTs and 23.3% all allo-HCTs. Overall survival for children after allo-HCT was: 70.1% at 5 years and 67.2% at 10 years, while after auto-HCT was 57.1% at 5 years and 49.0% at 10 years. Overall survival for adults after allo-HCT was: 55.1% at 5 years and 49.0% at 10 years, while after auto-HCT was 73.5% at 5 years and 64.5% at 10 years. 10-years overall survival for children after allo-HCT with respect to donor type was 70.5% for MSD-HCT; 67.2% for UD-HCT; 44.8% for haplo-HCT; while for adults 49.5% for MSD-HCT; 49.6% for UD-HCT; 38.8% for haplo-HCT. Higher survival rates were observed in children <10 vs >10 years, and in adults <25 years vs >25 years. 10-years overall survival after HCT improved with subsequent time periods both in children and adults. Conclusions Over a period of 40 years, increasing survival rates of allogeneic and autologous HCT are observed. There is an advantage in survival of younger patients.

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