Characteristics of centers performing HLA-identical sibling transplantation for patients with acute or chronic leukemia in the United States
Variables . | Center, no. (%) . | Patients, no. (%) . |
---|---|---|
No. of centers and patients | 88 | 1426 |
Procedure volume | ||
Total no. of transplants/y | ||
Median (range) | 70 (11-> 400) | |
30 transplants or fewer/y | 14 (16) | 55 (4) |
31-60 transplants/y | 20 (23) | 227 (16) |
61-99 transplants/y | 31 (35) | 380 (27) |
100 or more transplants/y | 23 (26) | 764 (54) |
Total no. of allogeneic transplants/y | ||
Median (range) | 28 (1-> 200) | |
10 transplants or fewer/y | 18 (20) | 88 (6) |
11-20 transplants/y | 18 (20) | 161 (11) |
21-39 transplants/y | 24 (28) | 391 (27) |
40 transplants or more/y | 28 (32) | 786 (55) |
Type of transplants performed | ||
Related transplantation | 88 (100) | 1426 (100) |
Unrelated transplantation | 62 (70) | 1165 (82) |
Cord blood transplantation | 33 (38) | 574 (40) |
Nonmyeloablative transplantation | 66 (75) | 1104 (77) |
Outpatient transplantation | 48 (54) | 918 (64) |
Years of center experience | ||
Median (range) | 11 (1-33) | |
Fewer than 8 y | 33 (38) | 259 (18) |
8-15 y | 30 (34) | 497 (35) |
More than 15 y | 25 (28) | 670 (47) |
Physician and health provider profile | ||
Transplantation physicians/center, median (range) | 4 (1-19) | |
Patient volume/y/MD | ||
Median (range) | 1:20 (1:3-1:48) | |
20 or fewer patients/1 MD | 762 (53) | |
More than 20 patients/1 MD | 664 (47) | |
Academic appointments of physicians | ||
None | 22 (25) | 225 (16) |
Some | 9 (10) | 202 (14) |
All | 57 (65) | 999 (70) |
Physicians with peer reviewed grants | 51 (58) | 970 (68) |
Physicians involved in research | 88 (100) | 1426 (100) |
Involved in laboratory research | 60 (68) | 1134 (80) |
Involved in clinical research | 88 (100) | 1426 (100) |
Medical school affiliations | 68 (77) | 1143 (77) |
Medical students and/or residents | 4 (6) | 57 (6) |
Hematology-oncology and/or BMT fellows | 24 (35) | 390 (35) |
All of the above | 40 (59) | 696 (59) |
Nurse-patient ratio | ||
1:1/1:2 | 34 (39) | 480 (34) |
1:3 | 43 (49) | 606 (42) |
1:4 or greater | 11 (12) | 340 (24) |
Transplant unit profile and resources | ||
Hospital bed capacity | ||
199 or fewer | 8 (9) | 72 (5) |
200-299 | 10 (11) | 83 (6) |
300-499 | 21 (24) | 263 (18) |
500 or more | 49 (56) | 1008 (71) |
Have devoted beds for BMT patients | 87 (99) | |
Median (range) | 12 (1-70) | |
Laminar air-flow rooms | ||
None | 54 (61) | 799 (56) |
Some | 18 (20) | 357 (25) |
All | 16 (18) | 270 (19) |
HEPA-filtered rooms | ||
None | 5 (5) | 66 (5) |
Some | 16 (18) | 313 (22) |
All | 67 (76) | 1047 (73) |
Percentage of patients enrolled in IRB-approved clinical protocols | ||
25% or less | 17 (19) | 177 (12) |
26%-50% | 21 (24) | 283 (20) |
More than 50% | 50 (57) | 966 (68) |
Full-time clinical research coordinators | ||
None | 9 (10) | 72 (5) |
1 FTE | 30 (34) | 319 (22) |
2 FTE | 21 (24) | 283 (20) |
3 FTE or more | 28 (32) | 752 (53) |
Units able to manage critically ill patients | 29 (33) | 559 (39) |
Computerized order entry | 67 (76) | 1130 (79) |
Electronic medical record-keeping | 51 (58) | 984 (69) |
On-site stem cell processing laboratory | 84 (95) | 1410 (99) |
Unit pharmacist present | 81 (92) | 1360 (95) |
NCI-designated cancer center | 28 (32) | |
Devoted psychologist/psychiatrist present | 54 (61) | 824 (58) |
Routine psychological screening done | 75 (85) | 1217 (85) |
Initial contact person | ||
Nurses/nurse practitioners/physician assistants | 18 (20) | 344 (24) |
Residents | 28 (32) | 466 (33) |
Hematology/oncology or BMT fellows | 37 (42) | 558 (39) |
Attendings | 5 (6) | 58 (4) |
Systematic follow-up of patients | 76 (86) | 1234 (86) |
Every 6 mo | 21 (24) | 422 (30) |
Every year | 40 (45) | 608 (43) |
Every other year | 15 (17) | 204 (14) |
No systematic follow-up | 12 (14) | 192 (13) |
Program has formal long-term follow-up program | 66 (75) | 1067 (75) |
Has formal posttransplant immunization protocol | 69 (78) | 1104 (78) |
Has formal protocol for screening posttransplant complications | 45 (51) | 733 (51) |
Medical center characteristics | ||
Geographic location | ||
Urban | 70 (80) | 1164 (82) |
Suburban/rural | 18 (20) | 262 (18) |
Center for Excellence designation | 63 (72) | 1187 (83) |
FACT accreditation | ||
No | 13 (15) | 196 (13) |
Yes, pending | 23 (26) | 290 (20) |
Yes | 52 (59) | 940 (66) |
Variables . | Center, no. (%) . | Patients, no. (%) . |
---|---|---|
No. of centers and patients | 88 | 1426 |
Procedure volume | ||
Total no. of transplants/y | ||
Median (range) | 70 (11-> 400) | |
30 transplants or fewer/y | 14 (16) | 55 (4) |
31-60 transplants/y | 20 (23) | 227 (16) |
61-99 transplants/y | 31 (35) | 380 (27) |
100 or more transplants/y | 23 (26) | 764 (54) |
Total no. of allogeneic transplants/y | ||
Median (range) | 28 (1-> 200) | |
10 transplants or fewer/y | 18 (20) | 88 (6) |
11-20 transplants/y | 18 (20) | 161 (11) |
21-39 transplants/y | 24 (28) | 391 (27) |
40 transplants or more/y | 28 (32) | 786 (55) |
Type of transplants performed | ||
Related transplantation | 88 (100) | 1426 (100) |
Unrelated transplantation | 62 (70) | 1165 (82) |
Cord blood transplantation | 33 (38) | 574 (40) |
Nonmyeloablative transplantation | 66 (75) | 1104 (77) |
Outpatient transplantation | 48 (54) | 918 (64) |
Years of center experience | ||
Median (range) | 11 (1-33) | |
Fewer than 8 y | 33 (38) | 259 (18) |
8-15 y | 30 (34) | 497 (35) |
More than 15 y | 25 (28) | 670 (47) |
Physician and health provider profile | ||
Transplantation physicians/center, median (range) | 4 (1-19) | |
Patient volume/y/MD | ||
Median (range) | 1:20 (1:3-1:48) | |
20 or fewer patients/1 MD | 762 (53) | |
More than 20 patients/1 MD | 664 (47) | |
Academic appointments of physicians | ||
None | 22 (25) | 225 (16) |
Some | 9 (10) | 202 (14) |
All | 57 (65) | 999 (70) |
Physicians with peer reviewed grants | 51 (58) | 970 (68) |
Physicians involved in research | 88 (100) | 1426 (100) |
Involved in laboratory research | 60 (68) | 1134 (80) |
Involved in clinical research | 88 (100) | 1426 (100) |
Medical school affiliations | 68 (77) | 1143 (77) |
Medical students and/or residents | 4 (6) | 57 (6) |
Hematology-oncology and/or BMT fellows | 24 (35) | 390 (35) |
All of the above | 40 (59) | 696 (59) |
Nurse-patient ratio | ||
1:1/1:2 | 34 (39) | 480 (34) |
1:3 | 43 (49) | 606 (42) |
1:4 or greater | 11 (12) | 340 (24) |
Transplant unit profile and resources | ||
Hospital bed capacity | ||
199 or fewer | 8 (9) | 72 (5) |
200-299 | 10 (11) | 83 (6) |
300-499 | 21 (24) | 263 (18) |
500 or more | 49 (56) | 1008 (71) |
Have devoted beds for BMT patients | 87 (99) | |
Median (range) | 12 (1-70) | |
Laminar air-flow rooms | ||
None | 54 (61) | 799 (56) |
Some | 18 (20) | 357 (25) |
All | 16 (18) | 270 (19) |
HEPA-filtered rooms | ||
None | 5 (5) | 66 (5) |
Some | 16 (18) | 313 (22) |
All | 67 (76) | 1047 (73) |
Percentage of patients enrolled in IRB-approved clinical protocols | ||
25% or less | 17 (19) | 177 (12) |
26%-50% | 21 (24) | 283 (20) |
More than 50% | 50 (57) | 966 (68) |
Full-time clinical research coordinators | ||
None | 9 (10) | 72 (5) |
1 FTE | 30 (34) | 319 (22) |
2 FTE | 21 (24) | 283 (20) |
3 FTE or more | 28 (32) | 752 (53) |
Units able to manage critically ill patients | 29 (33) | 559 (39) |
Computerized order entry | 67 (76) | 1130 (79) |
Electronic medical record-keeping | 51 (58) | 984 (69) |
On-site stem cell processing laboratory | 84 (95) | 1410 (99) |
Unit pharmacist present | 81 (92) | 1360 (95) |
NCI-designated cancer center | 28 (32) | |
Devoted psychologist/psychiatrist present | 54 (61) | 824 (58) |
Routine psychological screening done | 75 (85) | 1217 (85) |
Initial contact person | ||
Nurses/nurse practitioners/physician assistants | 18 (20) | 344 (24) |
Residents | 28 (32) | 466 (33) |
Hematology/oncology or BMT fellows | 37 (42) | 558 (39) |
Attendings | 5 (6) | 58 (4) |
Systematic follow-up of patients | 76 (86) | 1234 (86) |
Every 6 mo | 21 (24) | 422 (30) |
Every year | 40 (45) | 608 (43) |
Every other year | 15 (17) | 204 (14) |
No systematic follow-up | 12 (14) | 192 (13) |
Program has formal long-term follow-up program | 66 (75) | 1067 (75) |
Has formal posttransplant immunization protocol | 69 (78) | 1104 (78) |
Has formal protocol for screening posttransplant complications | 45 (51) | 733 (51) |
Medical center characteristics | ||
Geographic location | ||
Urban | 70 (80) | 1164 (82) |
Suburban/rural | 18 (20) | 262 (18) |
Center for Excellence designation | 63 (72) | 1187 (83) |
FACT accreditation | ||
No | 13 (15) | 196 (13) |
Yes, pending | 23 (26) | 290 (20) |
Yes | 52 (59) | 940 (66) |
BMT indicates bone marrow transplantation; IRB, institutional review board; FTE, full-time equivalent; FACT, Foundation for the Accreditation of Cellular Therapy.