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Multicenter Study
. 2025 Jun;60(6):851-856.
doi: 10.1038/s41409-025-02569-3. Epub 2025 Apr 10.

Impact of center volume on outcomes in allogeneic hematopoietic cell transplantation for children

Motohiro Kato  1 , Hideki Nakashone  2   3 , Keitaro Matsuo  4 , Yuri Ito  5 , Atsumi Yanagisawa  6 , Marie Ohbiki  6 , Ken Tabuchi  6 , Tatsuo Ichinohe  7 , Yoshiko Hashii  8 , Junya Kanda  9 , Hideki Goto  10 , Koji Kato  11 , Makoto Yoshimitsu  12 , Atsushi Sato  13 , Moeko Hino  14 , Kimikazu Matsumoto  15 , Kimikazu Yakushijin  16 , Yoshiko Atsuta  6 , Takahiro Fukuda  17
Affiliations
Multicenter Study

Impact of center volume on outcomes in allogeneic hematopoietic cell transplantation for children

Motohiro Kato et al. Bone Marrow Transplant. 2025 Jun.

Abstract

The impact of center volume on outcomes in pediatric hematopoietic cell transplantation (HCT) is not well established. We retrospectively analyzed data from a nationwide registry, including 6966 pediatric patients who underwent their first allogeneic HCT at 123 centers in Japan between 2001 and 2020. Centers were categorized by transplant volume as low volume centers (C1, the smallest number of transplantation), medium-low volume centers (C2), medium-high volume centers (C3), and high volume centers (C4, the greatest number of transplantation), and outcomes were compared across these categories. The analysis revealed no statistically significant differences in HCT outcomes among center categories. The 5-year OS by center category was 66.8% (95% CI 64.4-69.0%) for C1, 66.8% (95% CI 64.5-69.0%) for C2, 67.9% (95% CI 65.6-70.2%) for C3, and 68.3% (95% CI 65.9-70.6%) for C4. These results were consistent even when analysis was restricted to malignant and nonmalignant diseases. Our findings suggest that, unlike in adult HCT, outcomes for pediatric HCT are not significantly affected by center volume. These results indicate the consistent quality of care across centers, supporting the accessibility of HCT at various institutions for pediatric patients.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Overall survival according to the center category.
Patients who underwent transplantation at low volume centers (C1, the smallest number of transplantation), medium-low volume centers (C2), medium-high volume centers (C3), and high volume centers (C4, the greatest number of transplantation) are compared.
Fig. 2
Fig. 2. Overall survival of transplantation for malignant diseases according to the center category.
Patients who underwent transplantation at low volume centers (malignant-C1, the smallest number of transplantation), medium-low volume centers (malignant-C2), medium-high volume centers (malignant-C3), and high volume centers (malignant-C4, the greatest number of transplantation) are compared. a Overall survival, (b) disease free survival, (c) cumulative incidence of relapse, and (d) cumulative incidence of non-relapse mortality.
Fig. 3
Fig. 3. Overall survival of transplantation for non-malignant diseases according to the center category.
Patients who underwent transplantation at low volume centers (NM-C1, the smallest number of transplantation), medium-low volume centers (NM-C2), medium-high volume centers (NM-C3), and high volume centers (NM-C4, the greatest number of transplantation).
See this image and copyright information in PMC

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