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The effect of center experience on allogeneic hematopoietic cell transplantation outcomes in acute myeloid leukemia

Bone Marrow Transplantation volume 59, pages 541–549 (2024)Cite this article

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Abstract

This study aimed to address the prognostic impact of center experience based on the data of 7821 adults with acute myeloid leukemia who underwent allogeneic hematopoietic cell transplantation (HCT) from 2010 to 2019 in Japan, where medical care was provided within a uniform healthcare system. Center experience was defined based on the number of allogeneic HCTs performed for any indication during the study period, by which centers were divided into low-, intermediate-, and high-volume centers. After adjusting for known confounding factors, the risk of overall mortality was lowest for the high-volume centers and highest for the low-volume centers, with the difference between the center categories attributed primarily to the risk of relapse. Patients transplanted at high-volume centers had higher risks of acute and chronic graft-versus-host diseases but without an increased risk of non-relapse mortality (NRM). These findings reveal the presence of a center effect in allogeneic HCT conducted during the past decade in Japan, highlighting the difference in relapse based on center experience. The weaker effect on NRM compared with that on relapse suggests that the transplantation care quality is becoming equalized across the country.

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Fig. 1: Outcomes according to the center category.
Fig. 2: Outcomes of patients undergoing umbilical cord blood transplantation (UCBT) according to the center category.

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Data availability

The data of this study are not publicly available due to ethical restrictions that it exceeds the scope of the recipient/donor’s consent for research use in the registry. Data may be available from the corresponding author upon reasonable request and with permission of the JSTCT/JDCHCT.

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Acknowledgements

This work was supported in part by a grant from the Aichi Cancer Research Foundation, grant number: 2023-1-7 (MY), and a grant from the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development (AMED) (grant no. 19ek0510023h0003) (YA).

Author information

Authors and Affiliations

  1. Nagoya City University East Medical Center, Nagoya, Japan

    Masamitsu Yanada

  2. Aichi Cancer Center, Nagoya, Japan

    Masamitsu Yanada

  3. The Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

  4. Nagoya University Hospital, Nagoya, Japan

    Yachiyo Kuwatsuka

  5. Tottori University Hospital, Yonago, Japan

    Koji Kawamura

  6. National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  7. Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  8. Osaka International Cancer Institute, Osaka, Japan

    Yoshiko Hashii

  9. Hokkaido University Hospital, Sapporo, Japan

    Hideki Goto

  10. Kyushu University Hospital, Fukuoka, Japan

    Koji Kato

  11. Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan

    Fumihiko Ishimaru

  12. Miyagi Children’s Hospital, Sendai, Japan

    Atsushi Sato

  13. Tokai University School of Medicine, Isehara, Japan

    Makoto Onizuka

  14. Aichi Cancer Center Research Institute, Nagoya, Japan

    Keitaro Matsuo

  15. Osaka Medical and Pharmaceutical University, Osaka, Japan

    Yuri Ito

  16. Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan

    Atsumi Yanagisawa, Marie Ohbiki, Ken Tabuchi & Yoshiko Atsuta

  17. Aichi Medical University, Nagakute, Japan

    Marie Ohbiki & Yoshiko Atsuta

  18. Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junya Kanda

  19. The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Takaaki Konuma

Authors
  1. Masamitsu Yanada
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Contributions

MY designed the study, analyzed data, interpreted the results, and drafted the paper; SY, YK, K Kawamura, and TK interpreted results and edited the paper; TF, TI, YH, HG, K Kato, FI, AS, M Onizuka, KM, YI, AY, M Ohbiki, KT, YA, and JK contributed to data management, interpreted the results, and edited the paper; and all authors approved the final version of the paper.

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Correspondence to Masamitsu Yanada.

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Yanada, M., Yano, S., Kuwatsuka, Y. et al. The effect of center experience on allogeneic hematopoietic cell transplantation outcomes in acute myeloid leukemia. Bone Marrow Transplant 59, 541–549 (2024). https://doi.org/10.1038/s41409-024-02222-5

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