Impact of center volume on outcomes in allogeneic hematopoietic cell transplantation for children

TL;DR

This study found that the volume of transplants at a center does not significantly affect outcomes for children undergoing allogeneic hematopoietic cell transplantation.

Contribution

The study provides new evidence that center volume does not impact pediatric HCT outcomes, unlike in adults.

Findings

No statistically significant differences in HCT outcomes were found among center categories.

Five-year overall survival rates were similar across all center volume categories.

Results were consistent for both malignant and nonmalignant diseases.

Abstract

The impact of center volume on outcomes in pediatric hematopoietic cell transplantation (HCT) is not well established. We retrospectively analyzed data from a nationwide registry, including 6966 pediatric patients who underwent their first allogeneic HCT at 123 centers in Japan between 2001 and 2020. Centers were categorized by transplant volume as low volume centers (C1, the smallest number of transplantation), medium-low volume centers (C2), medium-high volume centers (C3), and high volume centers (C4, the greatest number of transplantation), and outcomes were compared across these categories. The analysis revealed no statistically significant differences in HCT outcomes among center categories. The 5-year OS by center category was 66.8% (95% CI 64.4–69.0%) for C1, 66.8% (95% CI 64.5–69.0%) for C2, 67.9% (95% CI 65.6–70.2%) for C3, and 68.3% (95% CI 65.9–70.6%) for C4. These results were consistent even when analysis was restricted to malignant and nonmalignant diseases. Our findings suggest that, unlike in adult HCT, outcomes for pediatric HCT are not significantly affected by center volume. These results indicate the consistent quality of care across centers, supporting the accessibility of HCT at various institutions for pediatric patients.

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