PURPOSE: A comprehensive quality management system called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. PATIENTS AND METHODS: Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline (> 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient's risks were adjusted for by their European Group for Blood and Marrow Transplantation score. RESULTS: Patient outcome was systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P = .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P = .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P = .01) for the accreditation (test for trend P = .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P < .01). CONCLUSION: Even with all the limitations of an observational study, these findings support the hypothesis that introduction of a comprehensive clinical quality management system is associated with improved outcome of patients after HSCT.
PURPOSE: A comprehensive quality management system called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. PATIENTS AND METHODS: Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline (> 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient's risks were adjusted for by their European Group for Blood and Marrow Transplantation score. RESULTS: Patient outcome was systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P = .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P = .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P = .01) for the accreditation (test for trend P = .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P < .01). CONCLUSION: Even with all the limitations of an observational study, these findings support the hypothesis that introduction of a comprehensive clinical quality management system is associated with improved outcome of patients after HSCT.
Authors: Sebastian Giebel; Myriam Labopin; Adalberto Ibatici; Paul Browne; Tomasz Czerw; Gerard Socie; Ali Unal; Slawomira Kyrcz-Krzemien; Andrea Bacigalupo; Hakan Goker; Mike Potter; Caroline L Furness; Grant McQuaker; Dietrich Beelen; Noel Milpied; Antonio Campos; Charles Craddock; Arnon Nagler; Mohamad Mohty Journal: Oncologist Date: 2016-02-11
Authors: T Ruutu; A Gratwohl; T de Witte; B Afanasyev; J Apperley; A Bacigalupo; F Dazzi; P Dreger; R Duarte; J Finke; L Garderet; H Greinix; E Holler; N Kröger; A Lawitschka; M Mohty; A Nagler; J Passweg; O Ringdén; G Socié; J Sierra; A Sureda; W Wiktor-Jedrzejczak; A Madrigal; D Niederwieser Journal: Bone Marrow Transplant Date: 2013-07-29 Impact factor: 5.483
Authors: C Chabannon; M Hildebrandt; S Scheding; A Humpe; M Lowdell; I Slaper-Cortenbach Journal: Bone Marrow Transplant Date: 2014-12-15 Impact factor: 5.483
Authors: Alois Gratwohl; Ronald Brand; Eoin McGrath; Anja van Biezen; Anna Sureda; Per Ljungman; Helen Baldomero; Christian Chabannon; Jane Apperley Journal: Haematologica Date: 2014-01-31 Impact factor: 9.941
Authors: Marcelo A Fernandez-Viña; Tao Wang; Stephanie J Lee; Michael Haagenson; Mahmoud Aljurf; Medhat Askar; Minoo Battiwalla; Lee-Ann Baxter-Lowe; James Gajewski; Ann A Jakubowski; Susana Marino; Machteld Oudshoorn; Steven G E Marsh; Effie W Petersdorf; Kirk Schultz; E Victoria Turner; Edmund K Waller; Ann Woolfrey; John Umejiego; Stephen R Spellman; Michelle Setterholm Journal: Blood Date: 2014-01-09 Impact factor: 22.113
Authors: M-J Jiménez; C Ferra; O García; F de Arriba; S Jiménez; A Insunza; M Calabuig; A Mantecon; J Sánchez; M Torres; P Balsalobre; J Linio; A Jiménez; E Feliu; J-M Ribera Journal: Bone Marrow Transplant Date: 2014-04-28 Impact factor: 5.483
Authors: Marcelo A Fernández-Viña; John P Klein; Michael Haagenson; Stephen R Spellman; Claudio Anasetti; Harriet Noreen; Lee Ann Baxter-Lowe; Pedro Cano; Neal Flomenberg; Dennis L Confer; Mary M Horowitz; Machteld Oudshoorn; Effie W Petersdorf; Michelle Setterholm; Richard Champlin; Stephanie J Lee; Marcos de Lima Journal: Blood Date: 2013-04-17 Impact factor: 22.113