Introduction of a Quality Management System and Outcome After Hematopoietic Stem-Cell Transplantation

Gratwohl, Aloïs; Brand, Ronald; Niederwieser, Dietger; Baldomero, Helen; Chabannon, Christian; Cornelissen, Jan J.; Witte, Théo de; Ljungman, Per; McDonald, Fiona E. J.; McGrath, Eoin; Passweg, Jakob; Peters, Christina; Rocha, Vanderson; Slaper‐Cortenbach, Ineke; Sureda, Anna; Thewis, André; Apperley, Jane F.

doi:10.1200/jco.2010.30.4121

Cited by 91 publications

(78 citation statements)

References 32 publications

(5 reference statements)

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“…22 It was confirmed in all disease categories, for all teams regardless of their JACIE accreditation status and for teams in high, middle or low income countries by World Bank Category. Furthermore, the analysis was extended to more than 100 000 patients with an autologus HSCT.…”

Section: Extension Of the Risk Scorementioning

confidence: 74%

The EBMT risk score

Gratwohl

2011

Bone Marrow Transplant

271

235

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The European Group for Blood and Marrow Transplantation (EBMT) risk score provides a simple tool to assess instantly chances and risks of hematopoietic SCT(HSCT) for an individual patient pre-transplant. Five factors, age of the patient, stage of the disease, time from diagnosis, donor type and donor recipient gender combination augment risk for an individual patient with increasing score from 0 as best to 7 as worst in an additive way. The score holds for all acquired hematological disorders, for allogeneic and autologous HSCT (score 0-5), is independent of the HSCT technology and is valid for standard or reduced intensity conditioning. Survival is uniformly worse for older patients, transplanted in advanced disease stage after a long-time interval and with a mismatched donor than for younger patients, transplanted soon in early stage with a well matched donor. Additional risk factors such as performance score, CMV serostatus or cytokine polymorphisms improve prediction but to different extents for low or high-risk patients. Comparative assessment of disease risk and global pre-transplant risk should guide decisions for each patient with his/her specific disease between HSCT and a non-transplant approach and replace the traditional 'donor vs no donor' with such a risk-adapted individualized strategy.

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Section: Extension Of the Risk Scorementioning

confidence: 74%

The EBMT risk score

Gratwohl

2011

Bone Marrow Transplant

271

235

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“…12 The recommendations have yielded documented impacts and improved outcome. 12 It is now time to arrive at similar widely accepted guidelines for some of the transplantation techniques. GVHD represents such a topic.…”

Section: Introductionmentioning

confidence: 99%

Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice

Ruutu

Gratwohl

Witte

et al. 2013

Bone Marrow Transplant

255

216

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working group of the European Group for Blood and Marrow Transplantation (EBMT) and the European LeukemiaNet (ELN) GVHD remains the major impediment to broader application of allogeneic haematopoietic SCT. It can be prevented completely, but at the expense of other complications, rejection, relapse or delayed immune reconstitution. No optimal prevention or treatment method has been defined. This is reflected by enormous heterogeneity in approaches in Europe. Retrospective comparisons between different policies, although warranted, do not give definite answers. In order to improve the present situation, an European Group for Blood and Marrow Transplantation and the European LeukemiaNet working group has developed in a Delphilike approach recommendations for prophylaxis and treatment of GVHD in the most common allogeneic transplant setting, transplantation from an HLA-identical sibling or unrelated donor for standard risk malignant disease. The working group proposes these guidelines to be adopted as routine standard in transplantation centres and to be used as comparator in systematic studies evaluating the advantages and disadvantages of practices differing from these recommendations.

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“…Inclusion criteria were as follows: (1) patients with AML in first CR1, excluding AML secondary to myelodysplastic syndrome (2) age X18 years, (3) HSCT from HLA-identical sibling (that is, compatible for HLA-A, -B and -DRB1, as analyzed using either serological or molecular techniques) or from HLA-matched unrelated donor (82% of patients/donors of were reported to be compatible for HLA-A, -B, -C, -DRB1 and -DQB1 that is, 10 out of 10 loci; 10% were matched for 8/8 loci; 8% were matched for 6/6 loci), (4) …”

Section: Criteria Of Selectionmentioning

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%

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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Introduction of a Quality Management System and Outcome After Hematopoietic Stem-Cell Transplantation

Abstract: Even with all the limitations of an observational study, these findings support the hypothesis that introduction of a comprehensive clinical quality management system is associated with improved outcome of patients after HSCT.

Cited by 91 publications

References 32 publications

The EBMT risk score

The EBMT risk score

Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice

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

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