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Time from Remission to Allogeneic Transplant – Acute Myeloid Leukemia – Methodology

Time from Remission to Allogeneic Transplant – Acute Myeloid Leukemia – Methodology
Short description of Indicator For acute myeloid leukemia (AML) patients, number of days from remission to allogeneic stem cell transplant.
Rationale for measurement Wait times are reported for many cancer services (e.g., time to treatment) and can be an indicator of access. This time to transplant indicator illustrates the timeliness of access to stem cell transplant services in Ontario for people with AML. The time from remission to transplant is a critical period that can influence clinical outcomes.
Evidence/references for rationale Schlenk, R. F., Döhner, K., Mack, S., Stoppel, M., Király, F., Götze, K.. ... & Grimminger, W. (2010). Prospective evaluation of allogeneic hematopoietic stem-cell transplantation from matched related and matched unrelated donors in younger adults with high-risk acute myeloid leukemia: German-Austrian trial AMLHD98A. Journal of clinical oncology, 28(30), 4642-4648.

Devine, S. M., Owzar, K., Blum, W., Mulkey, F., Stone, R. M., Hsu, J. W., ... & Soiffer, R. J. (2015). Phase II study of allogeneic transplantation for older patients with acute myeloid leukemia in first complete remission using a reduced-intensity conditioning regimen: results from Cancer and Leukemia Group B 100103 (Alliance for Clinical Trials in Oncology)/Blood and Marrow Transplant Clinical Trial Network 0502. Journal of Clinical Oncology, 33(35), 4167.

Jourdan, E., Boiron, J. M., Dastugue, N., Vey, N., Marit, G., Huguet, F. R., ... & Rossi, J. F. (2005). Early allogeneic stem cell transplantation for young adults with acute myeloblastic leukemia in first complete remission: An intent-to-treat analysis of the long-term experience of the BGMT group. Biology of Blood and Marrow Transplantation, 11(2), 17-18.
Calculations for the indicator Median, interquartile range, 10th and 90th percentile days from the date of remission to the date of transplant for all patients with AML who received an allogeneic stem cell transplant.
  • For calendar years 2014 to 2018 (AML allogeneic transplants)

Analysis:

  • The Specialized Services Oversight Information System (SSOIS) was used to identify transplants in calendar years 2014 to 2018 in Ontario.
  • The SSOIS was used to identify AML patients.
  • The SSOIS was used to identify the date of remission.
  • The Registered Persons Database (RPDB) was used to assign age at transplant.

Cases were excluded if the patient did not have a valid health insurance number.

Standardized Rate Calculation N/A
Unit N/A
Data sources
  • Specialized Services Oversight Information System, Ontario Health (Cancer Care Ontario)
  • Registered Persons Database, Ministry of Health
Time Frame 2014 to 2018
Geographic Scale Provincial
Denominator description N/A
Numerator description N/A
Considerations  N/A
Data availability & limitations The time to transplant depends on complete and accurate reporting of remission date and transplant data in SSOIS, and relies on the correct identification of cases (also in SSOIS). This data source is considered to be of high quality and accuracy.