Practice Patterns and Preferences Among Hematopoietic Cell Transplantation Clinicians

Area of Science:

• Hematology
• Transplantation Medicine
• Clinical Practice Research

Background:

• Hematopoietic cell transplantation (HCT) is a curative option for high-risk diseases.
• HCT is complex, costly, and carries inherent risks.
• The 2014 Blood and Marrow Transplant Clinical Trials Network State of the Science Symposium (BMT CTN SOSS) identified key research priorities.

Purpose of the Study:

• To survey HCT clinicians on current practices in BMT CTN SOSS priority areas.
• To assess variations in transplantation approaches and benefit estimations.
• To identify areas of clinical equipoise and data needs.

Main Methods:

• A survey was distributed to 1439 HCT clinicians.
• 305 clinicians responded, representing diverse demographics and practice settings.
• The survey focused on BMT CTN SOSS priority areas and general transplantation practices.

Main Results:

• Maintenance therapy for acute myeloid leukemia and myelodysplastic syndromes post-allogeneic HCT is used in practice, more so in high-volume centers.
• Significant variation exists in HCT technology use and approaches to common scenarios.
• Risk/benefit perceptions were consistent despite varied hypothetical scenarios.

Conclusions:

• Clinical equipoise exists in several BMT CTN SOSS priority areas.
• Current practices show significant variation among HCT clinicians.
• There is a clear need for robust data to inform and standardize HCT clinical practice.