Association of Human Development Index with rates and outcomes of hematopoietic stem cell transplantation for patients with acute leukemia

Giebel, Sebastian; Labopin, Myriam; Ehninger, Gerhard; Beelen, Dietrich; Blaise, Didier; Ganser, Arnold; Bacigalupo, Andrea; Czerw, Tomasz; Hołowiecki, Jerzy; Fagundes, Evandro M.; Nowara, Elżbieta; Frassoni, Francesco; Rocha, Vanderson; Transplantation, Marrow

doi:10.1182/blood-2010-01-266478

Cited by 38 publications

(35 citation statements)

References 25 publications

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“…In line with our previous findings, we confirmed the importance of the socio-economic status, which effect was independent on the center experience. 3 To better understand the reasons why the outcome differed between centers with very low activity and the remainder, and in particular to check if the patients preselection could be the cause, we performed additional 'post-hoc' analysis comparing transplant characteristics in centers belonging to the 1st and 2nd-5th quintile according to the RIC-HSCT activity. With the cutoff point of 15 RIC-HSCT procedures in 7 years (that is, 2.1/year) established empirically based on results of a univariate analysis, we found that the interval from diagnosis to transplantation was significantly longer for centers with low activity (median 169 days, range 53-560) compared with the remainders (median 157 days, range 28-997; P ¼ 0.002), while the interval from diagnosis to CR1 was equal: 47 days (range 14-175) and 47 days (range 10-256), respectively (P ¼ 0.73).…”

Section: )mentioning

confidence: 99%

“…However, even if all known risk factors are taken into account, transplant outcome remains highly variable, implying a role for other external factors such as the center experience, socio-economic status of a country or implementation of an international system accreditation of a transplant center. [1][2][3][4] The introduction of allo-HSCT with reduced-intensity conditioning (RIC-HSCT) has allowed application of transplantation procedures to patients with advanced age and significant comorbidities. [5][6][7][8] This option appears particularly important for diseases with prevalence in the elderly, like AML.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of center experience on results of reduced intensity: allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

Giebel

Labopin²,

Mohty

et al. 2012

Bone Marrow Transplant

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Section: )mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of center experience on results of reduced intensity: allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

Giebel

Labopin²,

Mohty

et al. 2012

Bone Marrow Transplant

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“…These factors are included in the prognostic scores elaborated by the European Group for Blood and Marrow Transplantation (EBMT) [1]. However, results of alloHCT may also depend on external factors, such as the transplant team and, more widely, the country where the procedure was performed [2,3]. The significance of external factors is much less well characterized and is rarely considered for interpretation of clinical studies on alloHCT.…”

Section: Introductionmentioning

confidence: 99%

Association of Macroeconomic Factors With Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation for Adults With Acute Lymphoblastic Leukemia: An Analysis From the Acute Leukemia Working Party of the EBMT

et al. 2016

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Acute lymphoblastic leukemia x Non-relapse mortality ABSTRACT Purpose. From a global perspective, the rates of allogeneic hematopoietic cell transplantation (alloHCT) are closely related to the economic status of a country. However, a potential association withoutcome hasnot yet been documented.The goal ofthis study was to evaluate effects of health care expenditure (HCE), Human Development Index (HDI),team density, and center experience on nonrelapsemortality(NRM)afterHLA-matchedsiblingalloHCTfor adults with acute lymphoblastic leukemia (ALL). Patients and Methods. A total of 983 patients treated with myeloablative alloHCT between 2004 and 2008 in 24 European countries were included. Results. In a univariate analysis, the probability of day 100 NRM was increased for countries with lower current HCE (8% vs. 3%; p 5 .06), countries with lower HDI (8% vs. 3%; p 5 .02), and centers with less experience (8% vs. 5%; p 5 .04). In addition, the overall NRM was increased for countries with lower current HCE (21% vs. 17%; p 5 .09) and HDI (21% vs. 16%; p 5 .03) and for centers with loweractivity (21% vs. 16%;p 5 .07). In a multivariate analysis,the strongest predictive model for day 100 NRM included current HCE greater than the median (hazard ratio [HR], 0.39; p 5 .002).The overall NRM was mostly predicted by HDI greater than the median (HR, 0.65; p 5 .01). Both lower current HCE and HDI were associated with decreased probability of overall survival. Conclusion. Both macroeconomic factors and the socioeconomic status of a country strongly influence NRM after alloHCT for adults with ALL. Our findings should be considered when clinical studies in the field of alloHCT are interpreted. The Oncologist 2016;21:377-383 Implications for Practice: Results of allogeneic hematopoietic cell transplantation (alloHCT) and other advanced oncological procedures may vary among countries and be related to various economic factors.This study, which included a homogenous population of patients with acute lymphoblastic leukemia, demonstrated significant associations of health care expenditure and the Human Development Index with nonrelapse mortality and overall survival after transplantation.The findings should be taken into account when clinical studies in the field of alloHCT are interpreted. The study should be followed by further investigation in other fields of oncology.

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“…In a recent study, Giebel et al 16 demonstrated that transplantations performed in countries belonging to the upper human development index category were associated with higher LFS compared with the remaining ones (HR ¼ 1.36, P ¼ 0.008). Moreover, a recent survey revealed that HCT is used for a broad spectrum of indications worldwide, but most frequently in countries with higher gross national incomes, higher governmental health-care expenditures, and higher team densities.…”

Section: Discussionmentioning

confidence: 99%

Allogeneic matched-sibling hematopoietic cell transplantation for AML: comparable outcomes between Eastern Mediterranean (EMBMT) and European (EBMT) centers

Bazarbachi

Labopin

Ghavamzadeh

et al. 2013

Bone Marrow Transplant

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Allogeneic hematopoietic cell transplantation (HCT) activity significantly increased in the Eastern Mediterranean area over the past decade. However, comparative outcomes with longer established centers, especially European Blood and Marrow Transplantation (EBMT) centers, have not been reported. We compared outcomes of matched-sibling allogeneic HCT between East Mediterranean Blood and Marrow Transplantation (EMBMT) and EBMT centers for adult patients with AML in first CR using myeloablative conditioning. We matched 431 patients from EMBMT with 431 patients from EBMT centers according to patient, disease and transplant characteristics. EMBMT recipients and donors were more likely to be CMV seropositive. There were no significant differences in the incidence of acute or chronic GVHD, or the 3-year cumulative incidence of non-relapse mortality (NRM) and relapse incidence (RI) between the two groups (NRM: EMBMT ¼ 16% vs EBMT ¼ 11), (RI: EMBMT ¼ 13% vs EBMT ¼ 19%). Notably, the 3-year leukemia-free survival (LFS) and OS were similar between the groups (LFS: EMBMT ¼ 70±2% vs EBMT ¼ 69±3%), (OS: EMBMT ¼ 74 ± 2% vs EBMT ¼ 73 ± 2%). Despite differences in socioeconomics, health resources and transplant experience, matched-sibling allogeneic HCT outcomes in emerging centers in the EMBMT region appear similar to EBMT centers.

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Association of Human Development Index with rates and outcomes of hematopoietic stem cell transplantation for patients with acute leukemia

Cited by 38 publications

References 25 publications

The impact of center experience on results of reduced intensity: allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

The impact of center experience on results of reduced intensity: allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

Association of Macroeconomic Factors With Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation for Adults With Acute Lymphoblastic Leukemia: An Analysis From the Acute Leukemia Working Party of the EBMT

Allogeneic matched-sibling hematopoietic cell transplantation for AML: comparable outcomes between Eastern Mediterranean (EMBMT) and European (EBMT) centers

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