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Providing both autologous and allogeneic hematopoietic stem cell transplants (HSCT) may have a stronger impact on the outcome of autologous HSCT in adult patients than activity levels or implementation of JACIE at Belgian transplant centres.

par Poirel, Hélène A;Vanspauwen, Marijke;Macq, Gilles;De Geyndt, Anke;Maertens, Johan;Willems, Evelyne;Selleslag, Dominik;Poiré, Xavier;Theunissen, Koen;Graux, Carlos;Kerre, Tessa;Zachée, Pierre;Meuleman, Nathalie ;De Becker, Anne ;Verlinden, Anke;Van Obbergh, Florence;Schuermans, Christine;De Wilde, Virginie ;Jaspers, Aurélie;Pranger, Delphine;Deeren, Dries;Van Riet, Ivan;Vaes, Evelien;Beguin, Yves;Belgian Transplant Registry and the Belgian Haematological Society’s Transplant committee,
Référence Bone marrow transplantation, 54, 9, page (1434-1442)
Publication Publié, 2019-09-01

Article révisé par les pairs

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Résumé :

While performance since the introduction of the JACIE quality management system has been shown to be improved for allogeneic hematopoietic stem cell transplants (HSCT), impact on autologous-HSCT remains unclear in Europe. Our study on 2697 autologous-HSCT performed in adults in 17 Belgian centres (2007-2013) aims at comparing the adjusted 1 and 3-yr survival between the different centres & investigating the impact of 3 centre-related factors on performance (time between JACIE accreditation achievement by the centre and the considered transplant, centre activity volume and type of HSCT performed by centres: exclusively autologous vs both autologous & allogeneic). We showed a relatively homogeneous performance between Belgian centres before national completeness of JACIE implementation. The 3 centre-related factors had a significant impact on the 1-yr survival, while activity volume and type of HSCT impacted the 3-yr survival of autologous-HSCT patients in univariable analyses. Only activity volume (impact on 1-yr survival only) and type of HSCT (impact on 1 and 3-yr survivals) remained significant in multivariable analysis. This is explained by the strong relationship between these 3 variables. An extended transplantation experience, i.e., performing both auto & allo-HSCT, appears to be a newly informative quality indicator potentially conveying a multitude of underlying complex factors.