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Hematopoietic Cell Transplantation Trends and Outcomes in Canada: A Registry-Based Cohort Study

Background: Hematopoietic cell transplantation (HCT) is an established therapy for hematologic malignancies and serious non-malignant blood disorders. Despite its curative potential, HCT is associated with substantial toxicity and health resource utilization. Effective delivery of HCT requires compl...

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Autores principales: Seftel, Matthew D., Pasic, Ivan, Parmar, Gaganvir, Bucher, Oliver, Allan, David S., Bhella, Sita, Hay, Kevin Anthony, Ikuomola, Oluwaseun, Musto, Grace, Prica, Anca, Richardson, Erin, Truong, Tony H., Paulson, Kristjan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669983/
https://www.ncbi.nlm.nih.gov/pubmed/37999143
http://dx.doi.org/10.3390/curroncol30110723
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author Seftel, Matthew D.
Pasic, Ivan
Parmar, Gaganvir
Bucher, Oliver
Allan, David S.
Bhella, Sita
Hay, Kevin Anthony
Ikuomola, Oluwaseun
Musto, Grace
Prica, Anca
Richardson, Erin
Truong, Tony H.
Paulson, Kristjan
author_facet Seftel, Matthew D.
Pasic, Ivan
Parmar, Gaganvir
Bucher, Oliver
Allan, David S.
Bhella, Sita
Hay, Kevin Anthony
Ikuomola, Oluwaseun
Musto, Grace
Prica, Anca
Richardson, Erin
Truong, Tony H.
Paulson, Kristjan
author_sort Seftel, Matthew D.
collection PubMed
description Background: Hematopoietic cell transplantation (HCT) is an established therapy for hematologic malignancies and serious non-malignant blood disorders. Despite its curative potential, HCT is associated with substantial toxicity and health resource utilization. Effective delivery of HCT requires complex hospital-based care, which limits the number of HCT centres in Canada. In Canada, the quantity, indications, temporal trends, and outcomes of patients receiving HCT are not known. Methods: A retrospective cohort study of first transplants reported to the Cell Therapy Transplant Canada (CTTC) registry between 2000 and 2019. We determined overall survival (OS) and non-relapse mortality (NRM), categorizing the cohort into early (2000–2009) and later (2010–2019) eras to investigate temporal changes. Results: Of 18,046 transplants, 7571 were allogeneic and 10,475 were autologous. Comparing the two eras, allogeneic transplants increased in number by 22.3%, with greater use of matched unrelated donors in the later era. Autologous transplants increased by 10.9%. Temporal improvements in NRM were observed in children and adults. OS improved in pediatric patients and in adults receiving autologous HCT. In adults receiving allogeneic HCT, OS was stable despite the substantially older age of patients in the later era. Interpretation: HCT is an increasingly frequent procedure in Canada which has expanded to serve older adults. Noted improvements in NRM and OS reflect progress in patient and donor selection, preparation for transplant, and post-transplant supportive care. In allogeneic HCT, unrelated donors have become the most frequent donor source, highlighting the importance of the continued growth of volunteer donor registries. These results serve as a baseline measure for quality improvement and health services planning in Canada.
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spelling pubmed-106699832023-11-17 Hematopoietic Cell Transplantation Trends and Outcomes in Canada: A Registry-Based Cohort Study Seftel, Matthew D. Pasic, Ivan Parmar, Gaganvir Bucher, Oliver Allan, David S. Bhella, Sita Hay, Kevin Anthony Ikuomola, Oluwaseun Musto, Grace Prica, Anca Richardson, Erin Truong, Tony H. Paulson, Kristjan Curr Oncol Article Background: Hematopoietic cell transplantation (HCT) is an established therapy for hematologic malignancies and serious non-malignant blood disorders. Despite its curative potential, HCT is associated with substantial toxicity and health resource utilization. Effective delivery of HCT requires complex hospital-based care, which limits the number of HCT centres in Canada. In Canada, the quantity, indications, temporal trends, and outcomes of patients receiving HCT are not known. Methods: A retrospective cohort study of first transplants reported to the Cell Therapy Transplant Canada (CTTC) registry between 2000 and 2019. We determined overall survival (OS) and non-relapse mortality (NRM), categorizing the cohort into early (2000–2009) and later (2010–2019) eras to investigate temporal changes. Results: Of 18,046 transplants, 7571 were allogeneic and 10,475 were autologous. Comparing the two eras, allogeneic transplants increased in number by 22.3%, with greater use of matched unrelated donors in the later era. Autologous transplants increased by 10.9%. Temporal improvements in NRM were observed in children and adults. OS improved in pediatric patients and in adults receiving autologous HCT. In adults receiving allogeneic HCT, OS was stable despite the substantially older age of patients in the later era. Interpretation: HCT is an increasingly frequent procedure in Canada which has expanded to serve older adults. Noted improvements in NRM and OS reflect progress in patient and donor selection, preparation for transplant, and post-transplant supportive care. In allogeneic HCT, unrelated donors have become the most frequent donor source, highlighting the importance of the continued growth of volunteer donor registries. These results serve as a baseline measure for quality improvement and health services planning in Canada. MDPI 2023-11-17 /pmc/articles/PMC10669983/ /pubmed/37999143 http://dx.doi.org/10.3390/curroncol30110723 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Seftel, Matthew D.
Pasic, Ivan
Parmar, Gaganvir
Bucher, Oliver
Allan, David S.
Bhella, Sita
Hay, Kevin Anthony
Ikuomola, Oluwaseun
Musto, Grace
Prica, Anca
Richardson, Erin
Truong, Tony H.
Paulson, Kristjan
Hematopoietic Cell Transplantation Trends and Outcomes in Canada: A Registry-Based Cohort Study
title Hematopoietic Cell Transplantation Trends and Outcomes in Canada: A Registry-Based Cohort Study
title_full Hematopoietic Cell Transplantation Trends and Outcomes in Canada: A Registry-Based Cohort Study
title_fullStr Hematopoietic Cell Transplantation Trends and Outcomes in Canada: A Registry-Based Cohort Study
title_full_unstemmed Hematopoietic Cell Transplantation Trends and Outcomes in Canada: A Registry-Based Cohort Study
title_short Hematopoietic Cell Transplantation Trends and Outcomes in Canada: A Registry-Based Cohort Study
title_sort hematopoietic cell transplantation trends and outcomes in canada: a registry-based cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669983/
https://www.ncbi.nlm.nih.gov/pubmed/37999143
http://dx.doi.org/10.3390/curroncol30110723
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