Ten-Year Trends of Hematopoietic Stem Cell Transplantation in Korean Pediatric Cancer from the National Health Insurance Claims Data
3
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose We aimed to determine the current application and survival trends of hematopoietic stem cell transplantation (HSCT) among Korean children and adolescents with cancer.Materials and Methods Data of patients aged < 20 years with KCD-10 (Korean Classifications of Diseases, 10th revision) C codes and specific designation codes were collected from the National Health Insurance Service database. Thirty claim codes for HSCT were included, and data from 2009 to 2019 were analyzed.Results The operational definition of pediatric cancer yielded an annual average of 2,000, with annual cases decreasing. In 2019, 221 HSCTs were performed, a decrease from the ten-year average of 276. Allografts outnumbered autografts with a ratio of 1.5:1. The source of allograft was bone marrow in 15% of patients in 2009; however, it substantially decreased to 3.3% in 2019. Furthermore, 70.5% of allogeneic HSCT used peripheral blood stem cell (PBSC) grafts, which increased to 89.3% by 2015. Cord blood utilization markedly decreased to 2.7% in 2018. The 5-year overall survival (OS) rate of all patients was 85.1%. Overall mortality decreased among patients who underwent recent HSCT, and they exhibited a higher 5-year OS rate.Conclusion In Korea, the number of pediatric patients with cancer is declining; however, the ratio of transplants to all patients remains constant. Patients who recently underwent transplantation showed better survival rates, possibly due to HSCT optimization. Korea showed a substantially greater PBSC utilization in pediatric HSCT. An in-depth examination encompassing donor relations and cause of death with a prospective registry is required in future studies.
Abstract
Purpose We aimed to determine the current application and survival trends of hematopoietic stem cell transplantation (HSCT) among Korean children and adolescents with cancer.Materials and Methods Data of patients aged < 20 years with KCD-10 (Korean Classifications of Diseases, 10th revision) C codes and specific designation codes were collected from the National Health Insurance Service database. Thirty claim codes for HSCT were included, and data from 2009 to 2019 were analyzed.Results The operational definition of pediatric cancer yielded an annual average of 2,000, with annual cases decreasing. In 2019, 221 HSCTs were performed, a decrease from the ten-year average of 276. Allografts outnumbered autografts with a ratio of 1.5:1. The source of allograft was bone marrow in 15% of patients in 2009; however, it substantially decreased to 3.3% in 2019. Furthermore, 70.5% of allogeneic HSCT used peripheral blood stem cell (PBSC) grafts, which increased to 89.3% by 2015. Cord blood utilization markedly decreased to 2.7% in 2018. The 5-year overall survival (OS) rate of all patients was 85.1%. Overall mortality decreased among patients who underwent recent HSCT, and they exhibited a higher 5-year OS rate.Conclusion In Korea, the number of pediatric patients with cancer is declining; however, the ratio of transplants to all patients remains constant. Patients who recently underwent transplantation showed better survival rates, possibly due to HSCT optimization. Korea showed a substantially greater PBSC utilization in pediatric HSCT. An in-depth examination encompassing donor relations and cause of death with a prospective registry is required in future studies.
참고문헌 (21)
- Snowden JA, "Indications for haema topoietic cell transplantation for haematological diseases, solid tumours and immune disorders : current practice in Europe, 2022", Bone Marrow Transplant, 57, pp.1217~1239 (2022)
- Calvo C, "Haematopoietic stem cell transplantation in adolescents and young adults with acute lymphoblastic leukaemia : special considerations and challenges", Front Pediatr, 9, pp.796426~ (2021)
- Lee JW, "Haploidentical family donor transplantation for pedi atric hematologic malignancies", Clin Pediatr Hematol Oncol, 28, pp.67~74 (2021)
- Im HJ, "Recent advances in haploidentical hematopoietic stem cell transplantation using ex vivo T cell depleted graft in children and adolescents", Blood Res, 51, pp.8~16 (2016)
- Jeong DC, "Current status of hematopoietic stem cell transplantation in Korean children", Korean J Hematol, 41, pp.235~242 (2006)
- Matthay KK, "Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cis-retinoic acid. Children’s Cancer Group", N Engl J Med, 341, pp.1165~1173 (1999)
- Sung KW, "Efficacy of tandem high-dose chemotherapy and autolo gous stem cell rescue in patients over 1 year of age with stage 4 neuroblastoma : the Korean Society of Pediatric Hematolo gy-Oncology experience over 6 years(2000-2005)", J Korean Med Sci, 25, pp.691~697 (2010)
- Kim H, "Pediatric cancer research using healthcare big data", Clin Pediatr Hematol Oncol, 29, pp.1~11 (2022)
- Chung H, "Clinical research from a health insurance database: practice and perspective", Korean J Med, pp.463~470 (2019)
- Lee JW, "The activity of hematopoietic stem cell transplantation in Korea", Bone Marrow Transplant, 42(Suppl 1), pp.S92~S95 (2008)
- Park HJ, "Incidence and survival of childhood cancer in Korea", Cancer Res Treat, 48, pp.869~882 (2016)
- Suh JK, "Feasi bility and effectiveness of treatment strategy of tandem high dose chemotherapy and autologous stem cell transplantation in combination with(131)I-MIBG therapy for high-risk neu roblastoma", Pediatr Transplant, 24, pp.e13658~ (2020)
- Park JE, "Efficacy of high-dose chemotherapy and autologous stem cell transplantation in patients with relapsed medulloblastoma : a report on the Korean Society for Pediatric Neuro-Oncology(KSPNO)-S-053 study", J Korean Med Sci, 25, pp.1160~1166 (2010)
- Sung KW, "Reduced-dose craniospinal radiotherapy followed by tandem high-dose chemotherapy and autologous stem cell transplan tation in patients with high-risk medulloblastoma", Neuro Oncol, 15, pp.352~359 (2013)
- D’Souza A, "Current use of and trends in hematopoietic cell trans plantation in the United States", Biol Blood Marrow Trans plant, 26, pp.e177~e182 (2020)
- Auletta JJ, "Current use and outcome of hematopoietic stem cell transplantation : CIBMTR US sum mary slides" (2021), Center for International Blood and Marrow Transplant Research
- "Annual number of BMT in Korea" (2022)[URL]
- Hopman RK, "Advances in stem cell mobilization", Blood Rev, 28, pp.31~40 (2014)
- Shimosato Y, "Allogeneic bone marrow transplanta tion versus peripheral blood stem cell transplantation for hematologic malignancies in children : a systematic review and meta-analysis", Biol Blood Marrow Transplant, 26, pp.8893~ (2020)
- Svenberg P, "Improved overall survival for pedi atric patients undergoing allogeneic hematopoietic stem cell transplantation : a comparison of the last two decades", Pediatr Transplant, 20, pp.667~674 (2016)
- Brissot E, "Improvement of overall survival after allogeneic hematopoietic stem cell transplantation for children and adolescents : a three-decade experience of a single institution", Bone Marrow Transplant, 51, pp.267~272 (2016)