National trends in Hematopoietic Stem Cell Transplantation and Cellular Therapy in Argentina: An Analysis of INCUCAI/SINTRA Data, 2019-2025

Abstract

Introduction: Hematopoietic stem cell transplantation (HSCT) is a cornerstone therapeutic strategy for both malignant and non-malignant diseases. Analysis of national registry data allows assessment of trends in transplant activity in Argentina. Materials and Methods: A retrospective descriptive study was conducted in collaboration between the National Institute for Centralized Coordination of Ablation and Implantation (INCUCAI) and the Argentine Group for Bone Marrow Transplantation and Cellular Therapy (GATMO-TC/SAH). HSCT procedures reported to the National Procurement and Transplant Information System of Argentina (SINTRA-INCUCAI) between 2019 and 2025 were analyzed. Autologous (Auto), related allogeneic (Allo-R), and unrelated allogeneic (Allo-URD) transplants were included. Information on CAR-T cell therapies was obtained directly from centers performing these procedures. Results: A total of 8,972 HSCT procedures were performed during the study period: 5,562 (62.0%) Auto, 2,470 (27.5%) Allo-R, and 940 (10.5%) Allo-URD. Among Allo-R, 1,319 were haploidentical and 1,151 HLA-identical sibling transplants. The highest annual activity was recorded in 2025, with 1,485 transplants and a national transplant rate of 320.8 per 10 million inhabitants. Activity was concentrated mainly in the City of Buenos Aires (4,164 procedures), Buenos Aires Province (2,282), and Córdoba (1,664). The number of transplant centers increased from 30 to 33 between 2019 and 2025. Mean recipient age was 42.8 ± 20.1 years; 84.4% were adults and 15.6% were pediatric patients. Autologous transplantation predominated in adults (68.9%), whereas allogeneic transplantation was more frequent in pediatric patients (75.6%). A progressive increase in transplants among patients aged ≥65 years was observed, reaching maximum ages of 84 years for autologous and 77 years for allogeneic transplantation. The main indications for autologous HSCT were multiple myeloma/plasma cell disorders (52.3%), non-Hodgkin lymphoma (21.0%), and Hodgkin lymphoma (16.9%). Among allogeneic transplants, acute lymphoblastic leukemia (29.3%), acute myeloid leukemia (28.7%), and myelodysplastic syndromes/myeloproliferative neoplasms (15.9%) were the leading indications. Social security financed 52.3% of procedures, followed by the private (29.0%) and public (18.7%) sectors. In addition, 12 CAR-T cell infusions were performed in three centers between 2023 and 2025. Discussion: HSCT activity in Argentina showed sustained growth between 2019 and 2025, with an increasing number of centers, geographic expansion, and record-high transplant rates. An increase in haploidentical transplantation and in procedures performed in older patients was observed. The CAR-T therapy data document the beginning of the national experience within the framework of clinical trials. These findings provide a comprehensive overview of recent HSCT trends in Argentina and may support future healthcare planning.