There are two voluntary center-accrediting organizations in the USA, the Foundation for the Accreditation of Cellular Therapy (FACT) and core Clinical Trial Network (CTN) certification, that are thought to improve and ensure hematopoietic cell transplantation (HCT) center quality care and certify clinical excellence. We sought to observe whether there are differences in outcomes between HLA-matched and -mismatched HCT by CTN and FACT status. Using the 2008-2010 Center for International Blood & Marrow Transplant Research data we created three center categories: non-FACT centers (24 centers), FACT-only certified centers (106 centers) and FACT and core clinical trial network (FACT/CTN) certified centers (32 centers). We identified patient characteristics within these centers and the relationship between FACT certification and survival. Our cohort consisted of 12 993 transplants conducted in 162 centers. After adjusting for patient and center characteristics we found that FACT/CTN centers had consistently superior results relative to non-FACT and FACT-only centers (P<0.05) especially for more complex HCT. However, non-FACT centers were comparable to FACT-only centers for matched related and unrelated patients. Although FACT status is an important standard of quality control that begins to define improved OS, our results indicate that FACT status alone is not an indicator for superior outcomes.
Bibliographical noteFunding Information:
The data presented here were obtained from the Statistical Center of the CIBMTR located at the Medical College of Wisconsin and the National Marrow Donor Program. The CIBMTR is partially supported by a Grant, U24-CA76518, from the National Institutes of Health, and by the Health Resources and Services Administration. CIBMTR comprises a voluntary working group of >450 transplantation centers worldwide that contribute detailed data on consecutive HCT to its statistical center. In addition, the CIBMTR holds the contract for the Stem Cell Therapeutic Outcomes Database part of the CW Bill Young Transplantation Program from the Human Resources and Services Administration. As a part of this program, all transplant centers in the USA are mandated to report clinical outcome data for allogeneic HCT to the CIBMTR. We obtained a de-identified data set from CIBTMR. The analysis has not been reviewed by the CIBMTR. Our study was deemed exempt from review by the Human Subjects Committee of the University of Minnesota’s Institutional Review Board.
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