Quality Measures for Blood & Marrow Transplants
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 of volumes of blood and marrow transplants done at Cedars-Sinai are summarized in the chart below:
| Type and Volume of Blood and Marrow Transplants Performed | Cedars-Sinai 2005 | Cedars-Sinai 2006 | Cedars-Sinai 2007 |
| Autologous transplants: These are blood and marrow transplants in which stems cells taken from a patient before chemotherapy or radiation are reintroduced afterward. | 94 | 63 | 79 |
| 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. | 19 | 24 | 22 |
Please note that a patient may receive more than one blood and marrow transplant. That is why in the chart above in 2006, there were 63 autologous transplants, while in the survival data below for autologous transplants done in 2006, only 59 patients are listed.
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 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 2003-2005 | Cedars-Sinai 2006 | Cedars-Sinai 2007 |
| For patients undergoing autologous blood and marrow transplantation, the median length of stay following the transplant was: | 14 | 13 | 13 |
| For patients undergoing allogeneic blood and marrow transplantation, the median length of stay following transplant was: | 26 | 26 | 22 |
| Median time to neutrophil engraftment: This is the average number of days before a transplant patient¿s immune system becomes strong enough to provide some protection against infection. | 12 | 12 | 11 |
| Median time to platelet engraftment: This is the average number of days before a transplant patient¿s blood is able to clot after an injury. | 15 | 14 | 15 |
Overall Satisfaction of Patients Receiving Blood & Marrow Transplants
In addition to measuring clinical factors leading to successful blood and marrow transplants, Cedars-Sinai Medical Center also measured the satisfaction of patients receiving transplant services.
The results of patient satisfaction surveys done among transplant patients at Cedars-Sinai Medical Center are summarized in the table below.
| When Patients Were Asked: | Number of Patients Surveyed | Cedars-Sinai | NCI Average Score | NCI Percentile Rank* |
| Wait time in Infusion Center area | 72 | 86.5 | 75.4 | 99 |
| Explanation given about what to expect during treatment | 72 | 90.6 | 87.9 | 92 |
| Treatment staff concern for patient's comfort | 73 | 93.5 | 91.8 | 91 |
| Treatment staff courtesy | 72 | 94.1 | 93 | 85 |
| Explanation given for managing side effects of chemotherapy | 72 | 87.5 | 87.7 | 50 |
| Comfort of the chemotherapy treatment area | 71 | 88.4 | 87.7 | 64 |
| Family kept informed as what to expect | 75 | 89.3 | 86 | 98 |
| Likelihood of recommending services | 91 | 94.8 | 93.6 | 66 |
| Doctor was sensitive to emotional impact of diagnosis | 90 | 87.1 | 86.7 | 59 |
| Doctor's discussion of treatment options | 91 | 90.4 | 88.2 | 86 |
| Diagnosis was explained in words easy to understand | 89 | 91 | 90.7 | 99 |
| Management of pain and other symptoms | 85 | 87.3 | 86.9 | 52 |
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.
Patients who received transplants between Jan. 1, 2003, and Dec. 31, 2005, are grouped together.
| Autologous Transplant Recipient Survival Rates | ||||
| 2003- 2005 Cumulative | 2006 | |||
| Number: | Percent: | Number: | Percent: | |
| Total patients: | 192 | 100% | 59 | 100% |
| Surviving 100 days: | 184 | 96% | 57 | 97% |
| Surviving one year: | 152 | 80% | -- | -- |
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 | ||||
| 2003 - 2005 Cumulative | 2006 | |||
| Number: | Percent: | Number: | Percent: | |
| Total patients: | 19 | 100% | 5 | 100% |
| Surviving 100 days: | 12 | 63% | 3 | 60% |
| Surviving one year: | 5 | 26% | -- | -- |
| Intermediate & Low-Risk Allogeneic Transplant Recipient Survival Rates | ||||
| 2003 - 2005 Cumulative | 2006 | |||
| Number: | Percent: | Number: | Percent: | |
| Total patients: | 11 | 100% | 14 | 100% |
| Surviving 100 days: | 9 | 82% | 12 | 86% |
| Surviving one year: | 8 | 73% | -- | -- |
