Why are there regional differences in stem cell transplantation activity? An EBMT analysis

Area of Science:

• Hematology
• Transplantation Medicine
• Health Services Research

Background:

• Global variations exist in hematopoietic stem cell transplant (HSCT) numbers, rates, indications, and techniques.
• These differences were previously attributed primarily to economic disparities and disease prevalence.

Purpose of the Study:

• To analyze factors influencing HSCT activity across diverse countries and transplant teams.
• To investigate the complex drivers behind international variations in HSCT procedures.

Main Methods:

• Analysis of 15 years of data from the European Blood and Marrow Transplantation (EBMT) annual activity survey.
• Inclusion of over 600 transplant teams from more than 40 countries.

Main Results:

• Gross national income per capita, transplant team density (per capita and per area), team size, and team experience significantly impact HSCT activity.
• The study reveals a more complex multifactorial situation than previously understood.

Conclusions:

• HSCT activity is influenced by a complex interplay of economic, infrastructural, and team-specific factors.
• Additional unknown factors contribute to decisions regarding HSCT performance.
• Further research is crucial to understand HSCT activity mechanisms and guide healthcare infrastructure development.