Statistics compiled by The Myeloma Beacon show there is sub­stan­tial variation across U.S. cancer centers in the num­ber of au­tol­o­gous (own) stem cell trans­plants the centers per­form each year for people with mul­ti­ple myeloma.

The five busiest U.S. centers in terms of au­tol­o­gous trans­plants for mul­ti­ple myeloma carried out an average of 236 such trans­plants per center in 2017, the latest year for which data are pub­licly avail­able. That is a pace equal to almost one trans­plant per weekday at each of the five centers.

In contrast, across the other 134 other U.S. centers that per­formed au­tol­o­gous trans­plants in mul­ti­ple myeloma patients in 2017, the average num­ber of such trans­plants per center was 47, or less than one trans­plant per week.

The statistics compiled by The Beacon also reveal that allo­geneic (donor) stem cell trans­plants for people with mul­ti­ple myeloma are very rare. In 2017, just 49 U.S. cancer centers per­formed allo­geneic stem cell trans­plants in patients with mul­ti­ple myeloma, and only three centers carried out more than 10 such pro­ce­dures during the entire year.

Across the 49 centers that per­formed allo­geneic trans­plants for mul­ti­ple myeloma patients in 2017, the average num­ber of such trans­plants for the year was less than 4 per center.

The stem cell trans­plant statistics compiled by The Beacon can be found in the re­port “Number Of Stem Cell Transplants Carried Out At U.S. Multiple Myeloma Treatment Centers,” which The Beacon pub­lished earlier to­day. The re­port features an inter­active table with trans­plant statistics for 149 U.S. cancer centers. Results in the table are likely to be of sig­nif­i­cant interest to patients, care­givers, and med­i­cal professionals in the U.S. and inter­na­tionally.

Autologous Stem Cell Transplants

Table 1 below lists in descending order the 20 U.S. cancer centers that in 2017 per­formed the most au­tol­o­gous (own) stem cell trans­plants for mul­ti­ple myeloma patients. The data in the table are a subset of the data in the broader Beacon re­port mentioned above.

The column in Table 1 labeled “MM” lists the num­ber of au­tol­o­gous trans­plants carried out at each center for patients with mul­ti­ple myeloma.

The column in Table 1 labeled “MM + Others” lists the num­ber of au­tol­o­gous trans­plants carried out at each center in patients with either mul­ti­ple myeloma, Hodgkin lym­phoma, or non-Hodgkin lym­phoma. From 2012 to 2106, au­tol­o­gous trans­plants for patients with these three dis­eases accounted for 89 per­cent of all au­tol­o­gous trans­plants carried out in the United States.

Table 1
U.S. Cancer Centers Performing The Most
Autologous Stem Cell Transplants
For Multiple Myeloma Patients In 2017

Many of the entries in Table 1 are centers one would ex­pec­t to be among the most active U.S. cancer centers when it comes to per­forming au­tol­o­gous stem cell trans­plants for people with mul­ti­ple myeloma. There are some entries, how­ever, that may come as a surprise to many Beacon readers, such as Northwestern Uni­ver­sity (Illinois), the Uni­ver­sity of Kansas, Barnes Jewish Hospital (Missouri), Froedtert Memorial Lutheran Hospital (Wisconsin), and the Colorado Blood Cancer In­sti­tute.

In general, the num­ber of trans­plants per­formed at a center will de­pend on

1. The number of myeloma patients regularly under the care of physicians at the center
2. How often physicians at the center recommend that their patients undergo autologous stem cell transplantation
3. How many transplants a patient at the center typically receives when they undergo autologous stem cell transplantation (that is, does the center typically perform single or tandem stem cell transplants?)

Of these three factors, the third is par­tic­u­larly im­por­tant. A center that prefers tandem stem cell trans­plan­ta­tion, which is two stem cell trans­plants carried out within a short period of time, can have double the num­ber of trans­plants each year com­pared to other centers with com­parable num­bers of myeloma patients and spe­cialists.

It should not come as a surprise, there­fore, that sev­er­al hos­pi­tals find themselves in Table 1 precisely because they are more likely than other centers to carry out tandem, rather than single, stem cell trans­plants. This is cer­tainly the case with the very first entry in the table, the Uni­ver­sity of Arkansas for Medical Sciences (UAMS), which has a long history of en­cour­ag­ing tandem stem cell trans­plan­ta­tion in myeloma patients under its care.

Tandem trans­plan­ta­tion also is likely to play a role in the re­­sults for Northwestern Medicine, Hackensack Uni­ver­sity Medical Center, and Mount Sinai Medical Center, which are centers with myeloma spe­cialists also more inclined to tandem trans­plan­ta­tion than spe­cialists at other centers.

Allogeneic Stem Cell Transplants

Table 2 below lists in descending order the 10 U.S. cancer centers that in 2017 per­formed the most allo­geneic (donor) stem cell trans­plants for mul­ti­ple myeloma patients. Once again, this table is a subset of the data in the broader Beacon re­port mentioned earlier.

The column in Table 2 labeled “MM” lists the num­ber of allo­geneic trans­plants carried out at each center for patients with mul­ti­ple myeloma.

The column in Table 2 labeled “MM + Others” lists the num­ber of allo­geneic trans­plants carried out at each center in patients with either mul­ti­ple myeloma, acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lym­phoma, myelo­dys­plastic syn­dromes (MDS), non-Hodgkin lym­phoma, or severe aplastic anemia. From 2012 to 2016, allo­geneic trans­plants for patients with these seven dis­eases accounted for 80 per­cent of all allo­geneic trans­plants carried out in the United States.

Table 2
U.S. Cancer Centers Performing
The Most Allogeneic Stem Cell Transplants
For Multiple Myeloma Patients In 2017

It’s clear from Table 2 that allo­geneic trans­plants for mul­ti­ple myeloma are rare, and just two or three U.S. cancer centers are per­forming such trans­plants reg­u­larly. Indeed, most of the centers in Table 2 are carrying out just single digit num­bers of allo­geneic trans­plants each year for mul­ti­ple myeloma patients.

This does not mean that allo­geneic trans­plants are generally rare at U.S. cancer centers. Indeed, sev­er­al of the centers listed in Table 2 are per­forming more than 200 allo­geneic trans­plants each year for dis­eases other than mul­ti­ple myeloma. The ex­peri­ence that comes from carrying out so many allo­geneic trans­plants in general may be a con­sid­er­a­tion when someone with mul­ti­ple myeloma is con­sidering where to have an allo­geneic trans­plant carried out.

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For au­tol­o­gous and allo­geneic stem cell trans­plant statistics for all U.S. cancer centers that per­formed trans­plants for mul­ti­ple myeloma patients in 2017, please be sure to consult the Beacon's detailed online re­port, "Number Of Stem Cell Transplants Carried Out At U.S. Multiple Myeloma Treatment Centers."