Does size matter? Center-specific characteristics and survival after allogeneic hematopoietic cell transplantation for acute myeloid leukemia: an analysis of the German Registry for Stem Cell Transplantation and Cell Therapy

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Wolfgang Bethge - , University Hospital Tübingen, Central Bone Marrow Donor Register for the Federal Republic of Germany (Author)
  • Sarah Flossdorf - , University Hospital Essen, Central Bone Marrow Donor Register for the Federal Republic of Germany (Author)
  • Franziska Hanke - , Central Bone Marrow Donor Register for the Federal Republic of Germany (Author)
  • Christoph Schmid - , University Hospital Augsburg (Author)
  • Mark Ringhoffer - , Städtischen Klinikum Karlsruhe (Author)
  • Stefan Klein - , Universitätsmedizin Mannheim (Author)
  • Bernd Hertenstein - , Klinikum Bremen-Mitte (Author)
  • Johannes Schetelig - , Department of Internal Medicine I (Author)
  • Matthias Stelljes - , University Hospital Münster (Author)
  • Thomas Schroeder - , University Hospital Essen (Author)
  • Igor Wolfgang Blau - , Charité – Universitätsmedizin Berlin (Author)
  • Francis Ayuk - , Central Bone Marrow Donor Register for the Federal Republic of Germany, University Hospital Hamburg Eppendorf (Author)
  • Matthias Eder - , Hannover Medical School (MHH) (Author)
  • Robert Zeiser - , University Medical Center Freiburg (Author)
  • Katharina Fleischhauer - , Central Bone Marrow Donor Register for the Federal Republic of Germany, University Hospital Essen (Author)
  • Nicolaus Kröger - , Central Bone Marrow Donor Register for the Federal Republic of Germany, University Hospital Hamburg Eppendorf (Author)
  • Peter Dreger - , University Hospital Heidelberg (Author)

Abstract

We investigated the effect of center-specific variables on overall survival (OS) after allogeneic hematopoietic cell transplantation (alloHCT) in acute myeloid leukemia (AML). Eligible for the study were adult patients reported to the German Registry for Hematopoietic Stem Cell Transplantation and Cell Therapy (DRST) receiving first alloHCT for AML from a related or matched (>9/10 HLA-match) unrelated donor in the period 2015-2021. Primary endpoint was OS at 12 months from alloHCT. Univariable and multivariable analyses after best subset selection were performed. Of 5,328 patients, 83% received alloHCT in a high-volume center (≥40 alloHCT/year), 90% in a university hospital, 90% in a center performing alloHCT for ≥10 years, and 73% in a Joint Accreditation Committee ISCT-Europe & European Group for Blood and Marrow Transplantation (EBMT) (JACIE) accredited center. 52% of the patients were in first CR, and European LeukemiaNet risk was adverse in 37% and intermediate in 42%. On multivariable analysis, center-specific factors predicting adverse 12-month OS were program duration <5-10 years (Hazard Ratio [HR] 1.23, [95% Confidence Interval: [1.02; 1.49]), center volume <40 alloHCT/year (HR 1.21, [1.02; 1.45]), and treatment at a non-university hospital (HR 1.21, [0.98; 1.49]), whereas JACIE accreditation did not. Spline modeling suggested a negative effect of a center volume up to 45 alloHCT per year. Center volume, center experience, university hospital, but not JACIE accreditation, have an impact on alloHCT outcomes in adult patients with AML in Germany.

Details

Original languageEnglish
Pages (from-to)1292-1303
Number of pages12
JournalHaematologica
Volume110
Issue number6
Early online date5 Dec 2024
Publication statusPublished - Jun 2025
Peer-reviewedYes

External IDs

unpaywall 10.3324/haematol.2024.286385
Scopus 105007355087
Mendeley 663434c1-85b3-3054-9818-7b943df1ae17

Keywords

Keywords

  • Humans, Hematopoietic Stem Cell Transplantation/methods, Leukemia, Myeloid, Acute/therapy, Male, Female, Middle Aged, Registries, Germany/epidemiology, Adult, Transplantation, Homologous, Aged, Young Adult, Adolescent, Cell- and Tissue-Based Therapy, Survival Rate

Library keywords