Characteristics of centers performing autologous transplantation for patients with lymphoma in the United States
Variables . | Centers, no. (%) . | Patients, no. (%) . |
|---|---|---|
| No. of centers | 142 | 2859 |
| Procedure volume | ||
| Total no. of transplants/y | ||
| Median (range) | 33 (2-> 400) | |
| 15 or fewer transplants/y | 40 (28) | 206 (7) |
| 16-35 transplants/y | 33 (23) | 347 (12) |
| 36-80 transplants/y | 34 (24) | 680 (24) |
| 80 or more transplants/y | 35 (25) | 1626 (57) |
| Total no. of autologous transplants/y | ||
| Median (range) | 25 (1-225) | |
| 10 or fewer transplants/y | 35 (25) | 115 (4) |
| 11-20 transplants/y | 32 (22) | 228 (8) |
| 21-39 transplants/y | 39 (27) | 525 (18) |
| 40 or more transplants/y | 36 (26) | 1991 (70) |
| Type of transplants performed | ||
| Outpatient transplantation | 78 (55) | 1916 (67) |
| Center experience | ||
| Years of experience | ||
| Median (range) | 10 (2-25) | |
| Fewer than 8 y | 43 (30) | 379 (13) |
| 8-15 y | 70 (49) | 1423 (50) |
| More than 15 y | 29 (21) | 1057 (37) |
| Physician and health provider profile | ||
| Transplantation physicians/center, median (range) | 4 (1-19) | |
| Patient volume/y/MD | ||
| Median (range) | 1:12 (1:3-1:48) | |
| 12 patients or fewer/1 MD | 71 (50) | 646 (23) |
| More than 12 patients/1 MD | 72 (50) | 2213 (77) |
| Academic appointments of physicians | ||
| None | 62 (44) | 868 (30) |
| Some | 14 (10) | 339 (12) |
| All | 65 (46) | 1652 (58) |
| Physicians with peer reviewed grants | 57 (40) | 1611 (56) |
| Physicians involved in research | 137 (96) | 2836 (99) |
| Involved in laboratory research | 69 (50) | 1829 (64) |
| Involved in clinical research | 137 (100) | 2836 (100) |
| Medical school affiliations | 92 (65) | 2158 (75) |
| Medical students and/or residents | 13 (14) | 138 (6) |
| Hematology-oncology and/or BMT fellows | 24 (26) | 669 (31) |
| All of the above | 55 (60) | 1351 (63) |
| Nurse-patient ratio | ||
| 1:1/1:2 | 64 (45) | 919 (32) |
| 1:3 | 57 (40) | 1472 (51) |
| 1:4 or greater | 21 (15) | 468 (17) |
| Transplant unit profile and resources | ||
| Hospital bed capacity | ||
| 199 or fewer | 19 (13) | 188 (7) |
| 200-299 | 14 (10) | 116 (4) |
| 300-499 | 42 (30) | 627 (22) |
| 500 or more | 67 (47) | 1928 (67) |
| Have devoted beds for BMT patients | ||
| Median (range) | 7 (1-70) | |
| Laminar air-flow rooms | ||
| None | 99 (70) | 1887 (66) |
| Some | 21 (15) | 474 (16) |
| All | 22 (15) | 498 (18) |
| HEPA-filtered rooms | ||
| None | 21 (15) | 329 (11) |
| Some | 20 (14) | 565 (20) |
| All | 101 (71) | 1965 (69) |
| Percentage of patients enrolled in IRB-approved clinical protocols | ||
| 25% or less | 36 (25) | 493 (17) |
| 26%-50% | 31 (22) | 679 (24) |
| More than 50% | 75 (53) | 687 (59) |
| Full-time clinical research coordinators | ||
| None | 23 (16) | 205 (7) |
| 1 FTE | 67 (47) | 800 (28) |
| 2 FTE | 26 (18) | 612 (21) |
| 3 FTE or more | 26 (18) | 1242 (43) |
| Units able to manage critically ill patients | 38 (27) | 940 (331) |
| Computerized order entry | 100 (70) | 2240 (78) |
| Electronic medical record-keeping | 74 (52) | 1911 (67) |
| On-site stem cell processing laboratory | 107 (75) | 2593 (91) |
| Unit pharmacist present | 121 (85) | 2633 (92) |
| NCI-designated cancer center | 30 (21) | 1153 (52) |
| Devoted psychologist/psychiatrist present | 84 (59) | 1663 (58) |
| Routine psychological screening done | 117 (82) | 2531 (88) |
| Initial contact person | ||
| Nurses/nurse practitioners/physician assistants | 31 (22) | 756 (27) |
| Residents | 1 (< 1) | 3(< 1) |
| Hematology/oncology or BMT fellows | 35 (25) | 1089 (38) |
| Attendings | 75 (53) | 1011 (35) |
| Systematic follow-up of patients done | 122 (86) | 2434 (85) |
| Every 6 mo | 45 (32) | 709 (25) |
| Every year | 57 (40) | 1293 (45) |
| Every other year | 20 (14) | 432 (15) |
| No systematic follow-up | 20 (14) | 425 (15) |
| Program has formal long-term follow-up program | 87 (61) | 1694 (59) |
| Has formal posttransplant immunization protocol | 105 (74) | 2275 (80) |
| Has formal protocol for screening posttransplant complications | 56 (39) | 1310 (46) |
| Medical center characteristics | ||
| Geographic location | ||
| Urban | 107 (75) | 2317 (81) |
| Suburban/rural | 35 (25) | 542 (19) |
| Center for Excellence designation | 93 (65) | 2433 (85) |
| FACT accreditation | ||
| No | 33 (23) | 333 (12) |
| Yes, pending | 40 (28) | 761 (27) |
| Yes | 69 (49) | 1765 (62) |
Variables . | Centers, no. (%) . | Patients, no. (%) . |
|---|---|---|
| No. of centers | 142 | 2859 |
| Procedure volume | ||
| Total no. of transplants/y | ||
| Median (range) | 33 (2-> 400) | |
| 15 or fewer transplants/y | 40 (28) | 206 (7) |
| 16-35 transplants/y | 33 (23) | 347 (12) |
| 36-80 transplants/y | 34 (24) | 680 (24) |
| 80 or more transplants/y | 35 (25) | 1626 (57) |
| Total no. of autologous transplants/y | ||
| Median (range) | 25 (1-225) | |
| 10 or fewer transplants/y | 35 (25) | 115 (4) |
| 11-20 transplants/y | 32 (22) | 228 (8) |
| 21-39 transplants/y | 39 (27) | 525 (18) |
| 40 or more transplants/y | 36 (26) | 1991 (70) |
| Type of transplants performed | ||
| Outpatient transplantation | 78 (55) | 1916 (67) |
| Center experience | ||
| Years of experience | ||
| Median (range) | 10 (2-25) | |
| Fewer than 8 y | 43 (30) | 379 (13) |
| 8-15 y | 70 (49) | 1423 (50) |
| More than 15 y | 29 (21) | 1057 (37) |
| Physician and health provider profile | ||
| Transplantation physicians/center, median (range) | 4 (1-19) | |
| Patient volume/y/MD | ||
| Median (range) | 1:12 (1:3-1:48) | |
| 12 patients or fewer/1 MD | 71 (50) | 646 (23) |
| More than 12 patients/1 MD | 72 (50) | 2213 (77) |
| Academic appointments of physicians | ||
| None | 62 (44) | 868 (30) |
| Some | 14 (10) | 339 (12) |
| All | 65 (46) | 1652 (58) |
| Physicians with peer reviewed grants | 57 (40) | 1611 (56) |
| Physicians involved in research | 137 (96) | 2836 (99) |
| Involved in laboratory research | 69 (50) | 1829 (64) |
| Involved in clinical research | 137 (100) | 2836 (100) |
| Medical school affiliations | 92 (65) | 2158 (75) |
| Medical students and/or residents | 13 (14) | 138 (6) |
| Hematology-oncology and/or BMT fellows | 24 (26) | 669 (31) |
| All of the above | 55 (60) | 1351 (63) |
| Nurse-patient ratio | ||
| 1:1/1:2 | 64 (45) | 919 (32) |
| 1:3 | 57 (40) | 1472 (51) |
| 1:4 or greater | 21 (15) | 468 (17) |
| Transplant unit profile and resources | ||
| Hospital bed capacity | ||
| 199 or fewer | 19 (13) | 188 (7) |
| 200-299 | 14 (10) | 116 (4) |
| 300-499 | 42 (30) | 627 (22) |
| 500 or more | 67 (47) | 1928 (67) |
| Have devoted beds for BMT patients | ||
| Median (range) | 7 (1-70) | |
| Laminar air-flow rooms | ||
| None | 99 (70) | 1887 (66) |
| Some | 21 (15) | 474 (16) |
| All | 22 (15) | 498 (18) |
| HEPA-filtered rooms | ||
| None | 21 (15) | 329 (11) |
| Some | 20 (14) | 565 (20) |
| All | 101 (71) | 1965 (69) |
| Percentage of patients enrolled in IRB-approved clinical protocols | ||
| 25% or less | 36 (25) | 493 (17) |
| 26%-50% | 31 (22) | 679 (24) |
| More than 50% | 75 (53) | 687 (59) |
| Full-time clinical research coordinators | ||
| None | 23 (16) | 205 (7) |
| 1 FTE | 67 (47) | 800 (28) |
| 2 FTE | 26 (18) | 612 (21) |
| 3 FTE or more | 26 (18) | 1242 (43) |
| Units able to manage critically ill patients | 38 (27) | 940 (331) |
| Computerized order entry | 100 (70) | 2240 (78) |
| Electronic medical record-keeping | 74 (52) | 1911 (67) |
| On-site stem cell processing laboratory | 107 (75) | 2593 (91) |
| Unit pharmacist present | 121 (85) | 2633 (92) |
| NCI-designated cancer center | 30 (21) | 1153 (52) |
| Devoted psychologist/psychiatrist present | 84 (59) | 1663 (58) |
| Routine psychological screening done | 117 (82) | 2531 (88) |
| Initial contact person | ||
| Nurses/nurse practitioners/physician assistants | 31 (22) | 756 (27) |
| Residents | 1 (< 1) | 3(< 1) |
| Hematology/oncology or BMT fellows | 35 (25) | 1089 (38) |
| Attendings | 75 (53) | 1011 (35) |
| Systematic follow-up of patients done | 122 (86) | 2434 (85) |
| Every 6 mo | 45 (32) | 709 (25) |
| Every year | 57 (40) | 1293 (45) |
| Every other year | 20 (14) | 432 (15) |
| No systematic follow-up | 20 (14) | 425 (15) |
| Program has formal long-term follow-up program | 87 (61) | 1694 (59) |
| Has formal posttransplant immunization protocol | 105 (74) | 2275 (80) |
| Has formal protocol for screening posttransplant complications | 56 (39) | 1310 (46) |
| Medical center characteristics | ||
| Geographic location | ||
| Urban | 107 (75) | 2317 (81) |
| Suburban/rural | 35 (25) | 542 (19) |
| Center for Excellence designation | 93 (65) | 2433 (85) |
| FACT accreditation | ||
| No | 33 (23) | 333 (12) |
| Yes, pending | 40 (28) | 761 (27) |
| Yes | 69 (49) | 1765 (62) |