On behalf of the EBMT Board and all the contributors, it is with great pleasure that I introduce this new edition of the ESH-EBMT Handbook on Haematopoietic Stem Cell Transplantation. The first edition of the Handbook appeared in 1998, when Professor Alois Gratwohl, a former President of EBMT, wrote “the present EBMT manual is a draft of a handbook which will hopefully one day become a standard tool in the daily management of patients undergoing blood or marrow stem cell transplantation”. There is no doubt that his vision has been fulfilled beyond expectation.
The EBMT Handbook has become the manual of choice for many doctors and practitioners involved in haematopoietic stem cell transplantation (HSCT). As a result of the outstanding efforts of the Editorial Board and the contributors, this current Handbook is a complete update of all aspects of HSCT. Within its twenty-four chapters, there is a comprehensive review of the current state-of-the-art in this difficult and challenging field. There is no doubt that during the past years significant contributions have helped to improve the outcome of HSCT and our deeper understanding of HLA-matching and other immunogenetic factors involved in donor selection has led to an increase in the number of unrelated bone marrow donors, which has reached nearly 20 million worldwide. We have also seen a significant increase in the use of peripheral haematopoietic stem cells instead of bone marrow, the increased use of cord blood transplantation with an increase in the number of cord blood banks, and an increase in the use of HSCT in older patients. We now have a deeper understanding of the knowledge of the management of graft-versus-host disease, post-transplant infections and late-effects.
Similarly, the field is changing with the development of new drugs either to support stem cell transplantation or to replace HSCT in the treatment of some conditions. However, despite all these developments, HSCT is still a procedure with a high mortality risk, and if this could be reduced significantly, HSCT could be of benefit in many other conditions. We have already begun to see the development of the application of stem cell transplantation in regenerative medicine and I am optimistic that this will become a main indication for stem cell transplantation. Therefore, I am convinced that the use of this Handbook on a daily basis will benefit not only doctors, but many patients as well.
The EBMT Board are extremely grateful to ESH, the Editorial Board, the contributors and to CHUGAI Sanofi-Aventis for an educational grant, which will permit the free distribution of this Handbook.
I wish all of you the best use of this Handbook and I am very grateful to you for making HSCT a safer procedure for many patients not just in Europe, but worldwide.
Professor Alejandro MadrigalPresident EBMT