Blood and Marrow Transplant Quality and Safety

The Cedars-Sinai Blood and Marrow Transplant Program continually monitors the care provided to patients who receive blood and marrow transplants. The results of this commitment to measuring the quality of patient care are reflected in the tables below.

Number of Blood & Marrow Transplants Performed Annually

Evidence indicates that medical centers that do more of a specific procedure tend to have better patient outcomes.

The types and volumes of blood and marrow transplants done at Cedars-Sinai are summarized in the chart below:

Types and Volumes of Blood and Marrow Transplants Performed at Cedars-Sinai Medical Center	2009	2010	2011
Autologous transplants: These are blood and marrow transplants in which stems cells taken from a patient before chemotherapy or radiation are reintroduced afterward.	97	91	83
Allogeneic transplants: These are blood and marrow transplants in which a patient receives stems from a donor (a relative or a charitable stranger) after having chemotherapy or radiation.	26	47	36

Length of Stay to Receive a Blood & Marrow Transplant

How long a person receiving a blood and marrow transplant has to stay in the hospital (average length of stay) is an indicator of the type of outcome he or she will have from the procedure.

In general, the less time a patient spends in the hospital, the better. People tend to recover better in a familiar setting; hospitals can be uncomfortable and inconvenient. A stay in a hospital can also expose patients to other illnesses.

Because allogenic transplants are more complex, people who undergo this type of blood and marrow transplant usually need to spend longer in the hospital. For people undergoing an autologous transplant, there are fewer potential complications. As a result, the length of their hospital stay tends to be shorter.

Data about the amount of time patients spent at Cedars-Sinai Medical Center while having a blood and marrow transplant are summarized below:

Length of Hospital Stay	Cedars-Sinai 2009		Cedars-Sinai 2010	Cedars-Sinai 2011
For patients undergoing autologous blood and marrow transplantation, the median length of stay following the transplant was:	18		16	18
For patients undergoing allogeneic blood and marrow transplantation, the median length of stay following transplantation was:	35		31	31
Average time to neutrophil engraftment: This was the average number of days before a transplant patient's immune system becomes strong enough to provide some protection against infection.	Auto	12	12	11
	Allo	16	16	19
Average time to platelet engraftment: This is the average number of days before a transplant patient's blood is able to clot after an injury.	Auto	18	18	19
	All	19	21	23

Blood and Marrow Transplant Outcomes

National standards have been set for measuring the success of a blood and marrow transplant. These standards are:

100-day survival rate: the percentage of patients who received a blood and marrow transplant who live 100 days after the transplant is done.
One-year survival rate: the percentage of patients who received a blood and marrow transplant who live one-year after the transplant is done.

For both standards, survival rates are calculated separately for autologous and allogeneic transplants.

Survival data by type of transplant is shown in the tables below.

Survival Rates for Persons Receiving an Autologous Transplant

The table below shows the number and percentage of patients who received blood and marrow transplants at Cedars-Sinai who survived 100 days and who survived one year.

Autologous Transplant Recipient Survival Rates
	2009		2010		2011
	No.	%	No.	%	No.	%
Total Patients:	97		91		83
Surviving 100 Days:	93	96%	87	97%	77	93%
Surviving One Year:	86	90%	80	88%	*	*

* Data not available until Dec. 31, 2012.

The number of transplants performed may be different from the number of patients receiving transplants because a patient may receive more than one blood and marrow transplant.

Survival Rates for Patients Receiving Allogeneic Transplants

When a patient receives an allogeneic blood and marrow transplant he or she is receiving stem cells from a donor -- usually a relative or a charitable stranger -- after having had chemotherapy or radiation.

Allogeneic transplants carry a greater level of risk than do autologous transplants.

In addition to showing 100-day and one-year survival rates, the tables below also show survival rates for patients who had a high risk transplant and those who had an intermediate or low risk transplant.

High-Risk Allogeneic Transplant Recipient Survival Rates
	2009		2010		2011
	No.	%	No.	%	No.	%
Total Patients:	5		16		7
Surviving 100 Days:	4	80%	10	63%	6	86%
Surviving One Year:	3	60%	5	31%	*	*

* Data not available until Dec. 31, 2012.

Intermediate and Low-Risk Allogenic Transplant Recipient Survival Rates
	2009		2010		2011
	No.	%	No.	%	No	%
Total Patients:	16		30		27
Surviving 100 Days:	14	88%	26	87%	23	87%
Surviving One Year:	9	56%	21	70%	*	*

* Data not available until Dec. 31, 2012.