Impact of Center Experience with Donor Type on Outcomes: A Secondary Analysis, Blood and Marrow Transplant Clinical Trials Network 1101Open for Accrual June 2012Open for Accrual June 2012

Blood and Marrow Transplant Clinical Trials Network

doi:10.1016/j.jtct.2022.03.024

Impact of Center Experience with Donor Type on Outcomes: A Secondary Analysis, Blood and Marrow Transplant Clinical Trials Network 1101Open for Accrual June 2012Open for Accrual June 2012

Blood and Marrow Transplant Clinical Trials Network

Medicine - Hematology, Oncology, Transplant

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

We previously reported the results of Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 1101, a randomized comparison of hematopoietic cell transplantation (HCT) performed with double umbilical cord blood units (dUCB) or with haploidentical bone marrow (haplo-BMT) with post-transplantation cyclophosphamide (PTCy) in the nonmyeloablative setting. Those results showed similar progression-free survival in the 2 treatment groups but lower nonrelapse mortality and better overall survival in the haplo-BM arm. In this secondary analysis, we sought to investigate whether transplantation center's previous experience with haplo-BM and/or dUCB HCT had an impact on outcomes. All patients randomized in BMT CTN 1101 were included. Center experience was assigned based on the number of transplantations with each platform performed in the year before initiation of the study according to the Center for International Blood and Marrow Transplant Research. Centers were then classified as a dUCB center (>10 dUCB HCTs; n = 117 patients, 10 centers), a haplo-BM center (>10 haplo-BM HCTs and ≤10 dUCB HCTs; n = 110 patients, 2 centers), or other center (≤10 haplo and ≤10 dUCB HCTs; n = 140 patients, 21 centers). After adjusting for age, Karnofsky Performance Status, and Disease Risk Index, we found that haplo-BM centers had lower overall mortality with this donor type compared with dUCB centers (hazard ratio [HR], 2.56; 95% confidence interval [CI], 1.44 to 4.56). In contrast, there were no differences in overall mortality between haplo-BM and dUCB in centers that were experienced with dUCB HCT (HR, 1.02; 95% CI, .59 to 1.79) or had limited to no experience with either dUCB or haplo-BM HCT (HR, 1.36; 95% CI, .83 to 2.21). The higher risk of treatment failure and overall mortality in dUCB HCT in haplo BM-experienced centers was driven by a significantly higher risk of relapse (HR, 1.78; 95% CI, 1.07 to 2.97). With the exception of worse outcomes among dUCB HCT recipients in haplo-BM centers, transplantation center experience in the year before initiation of BMT CTN 1101 had a limited impact on the outcomes of this randomized clinical trial.

Original language	English (US)
Pages (from-to)	406.e1-406.e6
Journal	Transplantation and Cellular Therapy
Volume	28
Issue number	7
DOIs	https://doi.org/10.1016/j.jtct.2022.03.024
State	Published - Jul 2022

Bibliographical note

Funding Information:
Financial disclosure: Support for this study was provided by Grants U10HL069294 and U24HL138660 to the BMT CTN from the National Heart, Lung, and Blood Institute and the National Cancer Institute of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the above-mentioned parties. The CIBMTR registry is supported primarily by Grant U24-CA76518 from the National Cancer Institute, National Heart, Lung, and Blood Institute, and National Institute of Allergy and Infectious Diseases and Grant HHSH234200637015C from the Health Resources and Services Administration, Department of Health and Human Services.

Publisher Copyright:
© 2022 The American Society for Transplantation and Cellular Therapy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Alternative donor transplantation
Cord blood
Haploidentical bone marrow
Transplantation center experience

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10.1016/j.jtct.2022.03.024

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Impact of Center Experience with Donor Type on Outcomes: A Secondary Analysis, Blood and Marrow Transplant Clinical Trials Network 1101Open for Accrual June 2012Open for Accrual June 2012. / Blood and Marrow Transplant Clinical Trials Network.
In: Transplantation and Cellular Therapy, Vol. 28, No. 7, 07.2022, p. 406.e1-406.e6.

Research output: Contribution to journal › Article › peer-review

@article{4958f90bb4004062b9ff558e56e404d1,

title = "Impact of Center Experience with Donor Type on Outcomes: A Secondary Analysis, Blood and Marrow Transplant Clinical Trials Network 1101Open for Accrual June 2012Open for Accrual June 2012",

abstract = "We previously reported the results of Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 1101, a randomized comparison of hematopoietic cell transplantation (HCT) performed with double umbilical cord blood units (dUCB) or with haploidentical bone marrow (haplo-BMT) with post-transplantation cyclophosphamide (PTCy) in the nonmyeloablative setting. Those results showed similar progression-free survival in the 2 treatment groups but lower nonrelapse mortality and better overall survival in the haplo-BM arm. In this secondary analysis, we sought to investigate whether transplantation center's previous experience with haplo-BM and/or dUCB HCT had an impact on outcomes. All patients randomized in BMT CTN 1101 were included. Center experience was assigned based on the number of transplantations with each platform performed in the year before initiation of the study according to the Center for International Blood and Marrow Transplant Research. Centers were then classified as a dUCB center (>10 dUCB HCTs; n = 117 patients, 10 centers), a haplo-BM center (>10 haplo-BM HCTs and ≤10 dUCB HCTs; n = 110 patients, 2 centers), or other center (≤10 haplo and ≤10 dUCB HCTs; n = 140 patients, 21 centers). After adjusting for age, Karnofsky Performance Status, and Disease Risk Index, we found that haplo-BM centers had lower overall mortality with this donor type compared with dUCB centers (hazard ratio [HR], 2.56; 95\% confidence interval [CI], 1.44 to 4.56). In contrast, there were no differences in overall mortality between haplo-BM and dUCB in centers that were experienced with dUCB HCT (HR, 1.02; 95\% CI, .59 to 1.79) or had limited to no experience with either dUCB or haplo-BM HCT (HR, 1.36; 95\% CI, .83 to 2.21). The higher risk of treatment failure and overall mortality in dUCB HCT in haplo BM-experienced centers was driven by a significantly higher risk of relapse (HR, 1.78; 95\% CI, 1.07 to 2.97). With the exception of worse outcomes among dUCB HCT recipients in haplo-BM centers, transplantation center experience in the year before initiation of BMT CTN 1101 had a limited impact on the outcomes of this randomized clinical trial.",

keywords = "Alternative donor transplantation, Cord blood, Haploidentical bone marrow, Transplantation center experience",

author = "\{Blood and Marrow Transplant Clinical Trials Network\} and Brunstein, \{Claudio G.\} and O'Donnell, \{Paul V.\} and Brent Logan and Peter Dawson and Luciano Costa and Corey Cutler and Michael Craig and William Hogan and Horowitz, \{Mary M.\} and Horwitz, \{Mitchell E.\} and Chatchada Karanes and Magenau, \{John M.\} and Adriana Malone and John McCarty and McGuirk, \{Joseph P.\} and Morris, \{Lawrence E.\} and Rezvani, \{Andrew R.\} and Rachel Salit and Sumithira Vasu and Mary Eapen and Fuchs, \{Ephraim J.\}",

note = "Funding Information: Financial disclosure: Support for this study was provided by Grants U10HL069294 and U24HL138660 to the BMT CTN from the National Heart, Lung, and Blood Institute and the National Cancer Institute of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the above-mentioned parties. The CIBMTR registry is supported primarily by Grant U24-CA76518 from the National Cancer Institute, National Heart, Lung, and Blood Institute, and National Institute of Allergy and Infectious Diseases and Grant HHSH234200637015C from the Health Resources and Services Administration, Department of Health and Human Services. Publisher Copyright: {\textcopyright} 2022 The American Society for Transplantation and Cellular Therapy",

year = "2022",

month = jul,

doi = "10.1016/j.jtct.2022.03.024",

language = "English (US)",

volume = "28",

pages = "406.e1--406.e6",

journal = "Transplantation and Cellular Therapy",

issn = "2666-6367",

publisher = "Elsevier B.V.",

number = "7",

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TY - JOUR

T1 - Impact of Center Experience with Donor Type on Outcomes

T2 - A Secondary Analysis, Blood and Marrow Transplant Clinical Trials Network 1101Open for Accrual June 2012Open for Accrual June 2012

AU - Blood and Marrow Transplant Clinical Trials Network

AU - Brunstein, Claudio G.

AU - O'Donnell, Paul V.

AU - Logan, Brent

AU - Dawson, Peter

AU - Costa, Luciano

AU - Cutler, Corey

AU - Craig, Michael

AU - Hogan, William

AU - Horowitz, Mary M.

AU - Horwitz, Mitchell E.

AU - Karanes, Chatchada

AU - Magenau, John M.

AU - Malone, Adriana

AU - McCarty, John

AU - McGuirk, Joseph P.

AU - Morris, Lawrence E.

AU - Rezvani, Andrew R.

AU - Salit, Rachel

AU - Vasu, Sumithira

AU - Eapen, Mary

AU - Fuchs, Ephraim J.

N1 - Funding Information: Financial disclosure: Support for this study was provided by Grants U10HL069294 and U24HL138660 to the BMT CTN from the National Heart, Lung, and Blood Institute and the National Cancer Institute of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the above-mentioned parties. The CIBMTR registry is supported primarily by Grant U24-CA76518 from the National Cancer Institute, National Heart, Lung, and Blood Institute, and National Institute of Allergy and Infectious Diseases and Grant HHSH234200637015C from the Health Resources and Services Administration, Department of Health and Human Services. Publisher Copyright: © 2022 The American Society for Transplantation and Cellular Therapy

PY - 2022/7

Y1 - 2022/7

N2 - We previously reported the results of Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 1101, a randomized comparison of hematopoietic cell transplantation (HCT) performed with double umbilical cord blood units (dUCB) or with haploidentical bone marrow (haplo-BMT) with post-transplantation cyclophosphamide (PTCy) in the nonmyeloablative setting. Those results showed similar progression-free survival in the 2 treatment groups but lower nonrelapse mortality and better overall survival in the haplo-BM arm. In this secondary analysis, we sought to investigate whether transplantation center's previous experience with haplo-BM and/or dUCB HCT had an impact on outcomes. All patients randomized in BMT CTN 1101 were included. Center experience was assigned based on the number of transplantations with each platform performed in the year before initiation of the study according to the Center for International Blood and Marrow Transplant Research. Centers were then classified as a dUCB center (>10 dUCB HCTs; n = 117 patients, 10 centers), a haplo-BM center (>10 haplo-BM HCTs and ≤10 dUCB HCTs; n = 110 patients, 2 centers), or other center (≤10 haplo and ≤10 dUCB HCTs; n = 140 patients, 21 centers). After adjusting for age, Karnofsky Performance Status, and Disease Risk Index, we found that haplo-BM centers had lower overall mortality with this donor type compared with dUCB centers (hazard ratio [HR], 2.56; 95% confidence interval [CI], 1.44 to 4.56). In contrast, there were no differences in overall mortality between haplo-BM and dUCB in centers that were experienced with dUCB HCT (HR, 1.02; 95% CI, .59 to 1.79) or had limited to no experience with either dUCB or haplo-BM HCT (HR, 1.36; 95% CI, .83 to 2.21). The higher risk of treatment failure and overall mortality in dUCB HCT in haplo BM-experienced centers was driven by a significantly higher risk of relapse (HR, 1.78; 95% CI, 1.07 to 2.97). With the exception of worse outcomes among dUCB HCT recipients in haplo-BM centers, transplantation center experience in the year before initiation of BMT CTN 1101 had a limited impact on the outcomes of this randomized clinical trial.

AB - We previously reported the results of Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 1101, a randomized comparison of hematopoietic cell transplantation (HCT) performed with double umbilical cord blood units (dUCB) or with haploidentical bone marrow (haplo-BMT) with post-transplantation cyclophosphamide (PTCy) in the nonmyeloablative setting. Those results showed similar progression-free survival in the 2 treatment groups but lower nonrelapse mortality and better overall survival in the haplo-BM arm. In this secondary analysis, we sought to investigate whether transplantation center's previous experience with haplo-BM and/or dUCB HCT had an impact on outcomes. All patients randomized in BMT CTN 1101 were included. Center experience was assigned based on the number of transplantations with each platform performed in the year before initiation of the study according to the Center for International Blood and Marrow Transplant Research. Centers were then classified as a dUCB center (>10 dUCB HCTs; n = 117 patients, 10 centers), a haplo-BM center (>10 haplo-BM HCTs and ≤10 dUCB HCTs; n = 110 patients, 2 centers), or other center (≤10 haplo and ≤10 dUCB HCTs; n = 140 patients, 21 centers). After adjusting for age, Karnofsky Performance Status, and Disease Risk Index, we found that haplo-BM centers had lower overall mortality with this donor type compared with dUCB centers (hazard ratio [HR], 2.56; 95% confidence interval [CI], 1.44 to 4.56). In contrast, there were no differences in overall mortality between haplo-BM and dUCB in centers that were experienced with dUCB HCT (HR, 1.02; 95% CI, .59 to 1.79) or had limited to no experience with either dUCB or haplo-BM HCT (HR, 1.36; 95% CI, .83 to 2.21). The higher risk of treatment failure and overall mortality in dUCB HCT in haplo BM-experienced centers was driven by a significantly higher risk of relapse (HR, 1.78; 95% CI, 1.07 to 2.97). With the exception of worse outcomes among dUCB HCT recipients in haplo-BM centers, transplantation center experience in the year before initiation of BMT CTN 1101 had a limited impact on the outcomes of this randomized clinical trial.

KW - Alternative donor transplantation

KW - Cord blood

KW - Haploidentical bone marrow

KW - Transplantation center experience

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UR - https://www.scopus.com/pages/publications/85130454080#tab=citedBy

U2 - 10.1016/j.jtct.2022.03.024

DO - 10.1016/j.jtct.2022.03.024

M3 - Article

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AN - SCOPUS:85130454080

SN - 2666-6367

VL - 28

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JO - Transplantation and Cellular Therapy

JF - Transplantation and Cellular Therapy

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ER -

Impact of Center Experience with Donor Type on Outcomes: A Secondary Analysis, Blood and Marrow Transplant Clinical Trials Network 1101Open for Accrual June 2012Open for Accrual June 2012

Abstract

Bibliographical note

UN SDGs

Keywords

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