The publication of The 2024 EBMT Activity Report: crossing one million HCTs and 20,000 CAR-T. A landmark in cellular therapy marks a defining moment for the transplant and cellular therapy community. Published in Bone Marrow Transplantation, the report captures decades of progress in haematopoietic cell transplantation (HCT) and cellular therapies across Europe and beyond.
We spoke with the report’s first authors, Raffaella Geco and Isabel Sánchez-Ortega, about the significance of the findings, the milestones achieved, and what the data reveal about the future of cellular therapy.
The EBMT has conducted an annual survey of HCT activity since 1990. Over the past 35 years, this initiative has grown into a database of more than 1 million transplants.
Q1: The report highlights two major milestones — one million HCTs and more than 20,000 CAR-T treatments. Why are these figures so significant for the field?
Raffaella Greco: These milestones are significant as they show both continuity and change in cellular therapy and immunotherapy.
The figure of more than one million HCTs reported to EBMT since 1990 reflects more than three decades of clinical practice, registry discipline, and collaboration across transplant centres. HCT remains one of the most complex and effective cellular therapies in haematology. It continues to be used across malignant and non-malignant diseases, and in 2024, allogeneic HCT reached its highest annual activity reported to date.
At the same time, the figure of more than 20,000 CAR-T treatments since 2018 shows the speed at which the field is evolving. In 2024 alone, CAR-T was reported in 6,082 patients, a 24.5% increase compared with 2023. This is no longer an emerging activity. It is becoming part of the therapeutic pathway for a broader range of malignant and non-malignant diseases.
What matters most is the relationship between these two milestones. HCT and CAR-T are both treatment options for patients affected by these diseases, which is why systematic activity reporting is essential: it helps capture and monitor how different cellular therapies are developing together, rather than as independent procedures.
Q2: Beyond the headline numbers, what makes the 2024 activity report different from previous editions?
Raffaella Greco: The 2024 report gives us a more detailed and clinically informative view of activity than previous editions.
First, the survey captured more granular disease categories and disease status across cellular therapies to more accurately reflect evolving trends of disease distribution.
Second, for the first time, the report includes specific indications for CAR-T and gene therapies. This is particularly important in the context of their rapid expansion, as it allows a more detailed assessment of evolving indications and disease status across different cellular and gene therapies.
Third, the report looks, for the first time at longitudinal trends and country-level variation. This helps us assess how transplant and cellular therapy systems recovered after the pandemic, how activity has evolved over the last decade, and where differences in access remain.
The result is a report that is more than an annual activity count. It is a benchmark for clinical practice, service planning, and future research.
Q3: The report refers to “systems resilience” and disparities across countries. Why was it important to include these insights?
Isabel Sánchez-Ortega: It was important because activity data are also health-system data.
HCT and CAR-T require highly specialised infrastructure. They depend on referral pathways, donor access, apheresis capacity, cell processing, intensive clinical monitoring, accreditation, reimbursement, and trained multidisciplinary teams. When we analyse activity across countries, we are also looking at the capacity of health systems to deliver complex care.
The pandemic made this particularly visible. HCT activity declined in 2020, but centres adapted through safety measures and prioritisation of urgent indications. The subsequent recovery, and the continued growth of allogeneic HCT and CAR-T, show resilience. But resilience was not uniform across countries.
Some countries have high procedure rates and well-established programmes, while others are experiencing rapid growth from a lower baseline. Both patterns are important, as they highlight where capacity is strong, where systems are still developing, where further support may be needed, and which indications most frequently drive the use of cellular therapies per country.
Q4: What do you hope clinicians, researchers, and policymakers will take away from this publication?
Isabel Sánchez-Ortega: For clinicians, we hope the report provides a clear benchmark. It shows how indications are evolving, how donor choices are changing, and how CAR-T, other cellular and gene therapies are being incorporated into clinical practice.
For researchers, the report identifies where the field is moving and where we need deeper evidence. The growth of CAR-T in lymphoid malignancies, the early expansion into autoimmune diseases, the reduction in some autologous transplant indications, and the continued rise of allogeneic HCT in myeloid diseases all raise important clinical questions.
For policymakers, the message is very direct. Cellular therapy is now a core part of modern haematology, but it cannot be delivered without planning. These treatments require investment in centres, workforce, quality systems, data infrastructure, and long-term follow-up.
The EBMT Activity Survey had a 93% return rate in 2024, with data from 688 centres across 53 countries. That gives EBMT a unique responsibility. These data should help health systems anticipate demand, assess, and make informed decisions.
The main takeaway is that the field is advancing, but access must advance with it. Scientific progress only reaches its full value when eligible patients can benefit from it.