• Internal medicine journal · Jun 2023

    Observational Study

    Activity and Outcomes of Autologous Stem Cell Transplantation in the Private Sector in Australia.

    • Karthik Nath, Yvette James, Debra Taylor, Raeina Gardner, Nicholas Rai, Robert S Ware, Kerry Taylor, James Morton, Simon Durrant, Ian Irving, and John Bashford.
    • Icon Cancer Centre, Brisbane, Queensland, Australia.
    • Intern Med J. 2023 Jun 1; 53 (6): 923929923-929.

    BackgroundFew Australasian autologous stem cell transplantation (ASCT) programmes perform ASCT in the private sector. Relatively little is known about ASCT outcomes in the private sector, which varies in care delivery models to the public system.AimsTo investigate transplantation activity and survival outcomes at Icon Cancer Centre's Brisbane-based private clinical and laboratory ASCT programme over a 23-year period.MethodsRetrospective, observational study of all adults who underwent ASCT at Icon between 1996 and 2018. Main outcome measures were transplant activity, overall survival (OS) and 100-day and 1-year transplant-related mortality (TRM). Outcomes were benchmarked against the Australasian Bone Marrow Transplant Recipient Registry (ABMTRR).ResultsBetween 1996 and 2018, 1676 ASCT were performed in 1454 patients. From 2010 to 2018, ASCT performed at Icon contributed 40% of all South East Queensland ASCT. In the past 5 years, 21% of Icon's patients were aged ≥70 years, compared with 5% across Australasia. For the entire cohort, 100-day and 1-year TRM was 1.1% and 1.7%, respectively, while for those aged ≥70 years, it was 2.0% and 3.1%. For ASCT performed between 2014 and 2018, 100-day and 1-year TRM was 0.8% and 1.4%, which was half the TRM rates reported by the ABMTRR. The 10-year post-transplant OS at Icon was higher than the ABMTRR data, across all disease subtypes.ConclusionWe report excellent OS and low TRM, demonstrating the critical role of the private sector in the administration of this highly complex therapy. The Icon ASCT programme is the largest ASCT contributor in Queensland. It is inclusive of patients aged ≥70 years, demonstrating low and acceptable TRM.© 2022 Royal Australasian College of Physicians.

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