Evaluation of centre and period effects in allogeneic haematopoietic stem cell transplantation in France.
We evaluated the effect of individual and collective factors on the outcome of allogeneic haematopoietic stem cell transplantation (HSCT) at 35 French centres. Individual factors included patient and transplantation characteristics. Collective factors were related to the period and centre in which HSCT was performed. Two centre factors were studied: centre experience (ie number of HSCT performed during the study period) and the type of centre (paediatric or adult). All patients receiving a first allogeneic HSCT in France between 1st January 1993 and 31st December 1997 were included in the study. The follow-up period ended on 31st December 1997. The final sample included 2756 subjects. We analysed overall survival (OS) and transplant-related mortality (TRM). Prognostic factors were identified by univariate and multivariate analysis, using Cox models. We found that centre experience had no significant effect on outcome. However, survival rates, whether determined on the basis of OS or TRM, were significantly higher in paediatric centres than in adult centres. Residual heterogeneity was found between adult centres. Survival rates were significantly higher for HSCT performed after 1st January 1996 than for those performed before this date.
Etablissement Français des Greffes, Paris, France. fmesnil001@efg.atrium.rss.fr
F
F
Mesnil
J-P
JP
Jouet
P
P
Tuppin
J-P
JP
Vernant
J-L
JL
Golmard
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005602:France / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D015996:Survival Rate; D014184:Transplantation, Homologous