Autologous stem cell transplantation in multiple myeloma patients: utilization patterns and hospital effects

Abstract

Evidence on volume outcome associations for autologous stem cell transplantation (ASCT) in multiple myeloma (MM) is limited. We investigated ASCT utilization patterns and volume outcome associations in the German National Registry for Stem Cell Transplants (DRST). MM patients with an upfront ASCT between 1998 and 2014 registered in the DRST were included. ASCT utilization increased strongly from 6% to 17% between 1999 and 2013 with the largest increase for patients aged 60–64 years (8–34%). The mean number of ASCTs conducted in the hospitals per year varied (quintiles, Q1:0.0–8.2 to Q5:31.0–102.7). Center volume was not associated with survival after upfront ASCT (lowest vs. highest center volume, hazard ratios and 95% confidence intervals: 0.95 (0.76–1.18), p = 0.92). Our findings may reflect a high standard of care and degree of specialization of centers performing ASCT for MM in Germany.

Keywords:

• Transplantation
• multiple myeloma
• utilization patterns
• volume-outcome relationship
• survival

Acknowledgements

The authors thank Franziska Strehle from the Deutsche Register für Stammzelltransplantation (DRST) for providing the data and administrative support.

Ethics approval and consent to participate

All patients provided written informed consent for de-identified data collection. The study was conducted in accordance with the Declaration of Helsinki and was approved by local ethics committee review boards from all participating institutions.

Author contributions

LJ, MM, HG and HB designed the study, performed the analyses and interpreted the data.

ME, KW, CS, CS, CL, HS, HE, NK, DB, PD and HG are members of the DRST and contributed data.

All authors approved the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author and the DRST on reasonable request.

Additional information

Funding

This work was supported partly by the German Cancer Aid (Deutsche Krebshilfe) [grant numbers 110446 and 70112090]. The funder had no role in the design of the study; the collection, analysis, or interpretation of the data; the writing of the manuscript; or the decision to submit the manuscript for publication.