The Worldwide Network of Blood and Marrow Transplantation (WBMT) pursues the mission of promoting hematopoietic cell transplantation (HCT) for instance by evaluating activities through member societies, national registries and individual centers. In 2016, 82,718 first HCT were reported by 1,662 HCT teams in 86 of the 195 World Health Organization member states representing a global increase of 6.2% in autologous HCT and 7.0% in allogeneic HCT and bringing the total to 1,298,897 procedures. Assuming a frequency of 84,000/year, 1.5 million HCT were performed by 2019 since 1957. Slightly more autologous (53.5%) than allogeneic and more related (53.6%) than unrelated HCT were reported. A remarkable increase was noted in haploidentical related HCT for leukemias and lymphoproliferative diseases, but even more in non-malignant diseases. Transplant rates (TR; HCT/10 million population) varied according to region reaching 560.8 in North America, 438.5 in Europe, 76.7 in Latin America, 53.6 in South East Asia/Western Pacific (SEA/WPR) and 27.8 in African/East Mediterranean (AFR/EMR). Interestingly, haploidentical TR amounted to 32% in SEA/WPR and 26% in Latin America, but only 14% in Europe and EMR and 4.9% in North America of all allogeneic HCT. HCT team density (teams/10 million population) was highest in Europe (7.7) followed by North America (6.0), SEA/WPR (1.9), Latin America (1.6) and AFR/EMR (0.4). HCT are increasing steadily worldwide with narrowing gaps between regions and greater increase in allogeneic compared to autologous activity. While related HCT is rising, largely due to increase in haploidentical HCT, unrelated HCT is plateauing and cord blood HCT is in decline.

Sinusoidal obstruction syndrome, also known as veno-occlusive disease (SOS/VOD), is a potentially life-threatening complication that can develop after hematopoietic cell transplantation (HCT). A new definition for diagnosis, and a severity grading system for SOS/VOD in adult patients, was reported a few years ago on behalf of the European Society for Blood and Marrow Transplantation (EBMT). The aim of this work is to update knowledge regarding diagnosis and severity assessment of SOS/VOD in adult patients, and also its pathophysiology and treatment. In particular, we now propose to refine the previous classification and distinguish probable, clinical and proven SOS/VOD at diagnosis. We also provide an accurate definition of multiorgan dysfunction (MOD) for SOS/VOD severity grading based on Sequential Organ Failure Assessment (SOFA) score.

Artificial intelligence has revolutionized medical diagnosis, particularly for cancers. Acute myeloid leukemia (AML) diagnosis is a tedious protocol that is prone to human and machine errors. In several instances, it is difficult to make an accurate final decision even after careful examination by an experienced pathologist. However, computer-aided diagnosis (CAD) can help reduce the errors and time associated with AML diagnosis. White Blood Cells (WBC) detection is a critical step in AML diagnosis, and deep learning is considered a state-of-the-art approach for WBC detection. However, the accuracy of WBC detection is strongly associated with the quality of the extracted features used in training the pixel-wise classification models. CAD depends on studying the different patterns of changes associated with WBC counts and features. In this study, a new hybrid feature extraction method was developed using image processing and deep learning methods. The proposed method consists of two steps: 1) a region of interest (ROI) is extracted using the CMYK-moment localization method and 2) deep learning-based features are extracted using a CNN-based feature fusion method. Several classification algorithms are used to evaluate the significance of the extracted features. The proposed feature extraction method was evaluated using an external dataset and benchmarked against other feature extraction methods. The proposed method achieved excellent performance, generalization, and stability using all the classifiers, with overall classification accuracies of 97.57% and 96.41% using the primary and secondary datasets, respectively. This method has opened a new alternative to improve the detection of WBCs, which could lead to a better diagnosis of AML.

Recent advancements in artificial intelligence (AI) have led to numerous medical discoveries. The field of computer vision (CV) for medical diagnosis has received particular attention. Using images of peripheral blood (PB) smears, CV has been utilized in hematology to detect acute leukemia (AL). Significant research has been undertaken in the area of AL diagnosis automation in order to deliver an accurate diagnosis. This study addresses the morphological classification of atypical white blood cells (WBCs), including immature WBCs and atypical lymphocytes, in acute myeloid leukemia (AML), as observed in peripheral blood (PB) smear images. The purpose of this work is to build a classification model for atypical AML WBCs based on their distinctive features. Using a hybrid model based on geometric transformation (GT) and a deep convolutional autoencoder (DCAE), this work provides a novel technique in the field of AI for resolving the issue of imbalanced distribution of WBCs in blood samples, nicknamed the “GT-DCAE WBC augmentation model”. In addition, to extract context-free atypical WBC features, this study develops a stable learning paradigm by incorporating WBC segmentation into deep learning. In order to classify atypical WBCs into eight distinct subgroups, a hybrid multiclassification model termed the “two-stage DCAE-CNN atypical WBC classification model” (DCAE-CNN) was developed. The model achieved an average accuracy of 97%, a sensitivity of 97%, and a precision of 98%. Overall and by class, the model’s discriminating abilities were exceptional, with an AUC of 99.7% and a class-wise range of 80% to 100%.

In the setting of a learning collaborative, we conducted an international multicenter phase 2 clinical trial testing the hypothesis that nonmyeloablative–related haploidentical bone marrow transplant (BMT) with thiotepa and posttransplant cyclophosphamide (PTCy) will result in 2-year event-free survival (no graft failure or death) of at least 80%. A total of 70 participants were evaluable based on the conditioning protocol. Graft failure occurred in 8 of 70 (11.4%) and only in participants aged <18 years; all had autologous reconstitution. After a median follow-up of 2.4 years, the 2-year Kaplan-Meier–based probability of event-free survival was 82.6%. The 2-year overall survival was 94.1%, with no difference between children and adult participants. After excluding participants with graft failure (n = 8), participants with engraftment had median whole blood donor chimerism values at days +180 and +365 after transplant of 100% (n = 58), respectively, and 96.6% (57/59) were off immunosuppression 1 year after transplant. The 1-year grade 3 to 4 acute graft-versus-host disease (GVHD) rate was 10%, and the 2-year moderate–severe chronic GVHD rate was 10%. Five participants (7.1%) died from infectious complications. We demonstrate that nonmyeloablative haploidentical BMT with thiotepa and PTCy is a readily available curative therapy for most adults, even those with organ damage, compared to the more expensive myeloablative gene therapy and gene editing. Additional strategies are required for children to decrease graft failure rates. The trial was registered at www.clinicaltrials.gov as #NCT01850108.

The current COVID-19 pandemic, caused by SARS-CoV-2, has impacted many facets of hematopoietic cell transplantation (HCT) in both developed and developing countries. Realizing the challenges as a result of this pandemic affecting the daily practice of the HCT centers and the recognition of the variability in practice worldwide, the Worldwide Network for Blood and Marrow Transplantation (WBMT) and the Center for International Blood and Marrow Transplant Research's (CIBMTR) Health Services and International Studies Committee have jointly produced an expert opinion statement as a general guide to deal with certain aspects of HCT, including diagnostics for SARS-CoV-2 in HCT recipient, pre- and post-HCT management, donor issues, medical tourism, and facilities management. During these crucial times, which may last for months or years, the HCT community must reorganize to proceed with transplantation activity in those patients who urgently require it, albeit with extreme caution. This shared knowledge may be of value to the HCT community in the absence of high-quality evidence-based medicine.