Mirror Mirror on the Wall Who has the Best Allo Survival of Them All?


I will give you 10 guesses. It is the Blood and Marrow Transplant Program at Northside Hospital in Atlanta, Georgia. They qualify this as non related matching donor transplants, which  is a very difficult kind of transplant.  It is quite the surprise to see it is not one of the famous nationally known hospitals that one might think would be the best.  I am always on the lookout for survival statistics for multiple myeloma, and as anybody knows who has looked for hard data by hospital, it is difficult to come by.  So in my search I came across an article published by the Northside Hospital which identified their allogeneic transplant program as the best in the nation for 1st year survival. The  one hundred day and  the 1 year survival statistics are very important measures of success for an allogeneic transplant program.  One very important point of note is that the vast majority of this data is for other blood cancers and lymphoma, and only a very small percentage is for multiple myeloma.  The allo continues to be a rare procedure for myeloma patients. One of the reasons for this low usage is the high occurrence of Graft vs. Host Disease where the bodies own immune system turns against the donor stem cells and creates some nasty side effects.  However, a breakthrough clinical trial using Velcade during the allo transplant has shown great results in mitigating Graft vs. Host.  Pat Killingsworth is doing a multiple part blog post on a patient going through this trial and you can read the first post by CLICKING HERE, and view all parts by going to http://multiplemyelomablog.com/   Dr. Hari of the Medical College of Wisconsin was recent interviewed on the mPatient.org Radio Program about their allo program.  Dr. Hari’s results are some of the best in the United States with a 74% first year survival, and you can hear this program if you CLICK HERE

You can read the newsletter by Northside Hospital if you CLICK HERE. Two very interesting graphs compare Northside’s data against other programs in its region of the country and against the best known national programs.  The graphs are noted below:

On the first graph the Northside hospital data has a death rate of 21%, whereas the last one on the graph for Southeastern Transplant Centers has a death rate of  48%, so you are 2.3 times more likely to survive 1 year under the care of the doctors at Northside Hospital.  And if you look at the second graph you are also 2.2 times more likely to survive one year at NSH than at the nationally known Emory or Johns Hopkins facilities.  Of the 152 allo transplants at Northside, only 5 were myeloma patients, and of these 5, 4 were alive at one year.  This is 80%, or equal to their overall number of 79%, however 5 transplants is just too small a sample to be statistically significant. This is just 3% of total allo transplants at Northside for myeloma patients, and this is fairly representative of what you will find for a national average.

You can find data for all of the Allogeneic programs that report data to the National Marrow Donor Program (NMDP) if you CLICK HERE.  It will show a listing by state, and you just click on the name and review all of their data by disease type. 

Now, what is the take away from these findings.  First, if you are a cancer patient who can benefit from an allo (mainly leukemia and lymphoma) the data is there for you to choose a location that is at least 2 times more likely to keep you alive for the first year. All of the locations listed on the NMDP site has this data and should be able to tell you, and if they do not you can now find it yourself. Unfortunately,  these same locations also have similar data for survival for the auto transplant, but have as yet chosen not to make this public. However they do have access to this information and should be able to provide it to you.  If they do not give it to you, they are either unaware of its existence, or just are afraid to provide their below average performance to their patients.  What should be happening is locations that are not performing to the highest standard for allos should be finding out what the Northside Hospitals of the world are doing that make them the best of the best and duplicate it in their practice.  

I think what the NMDP is doing for the allo is a game changer, and very brave of all the membership hospitals that has chosen to participate, however it should be expanded to include the auto transplant, and ultimately for all cancers.  This is the vision that Dr. Hofmeister has for myeloma and would be expandable to all cancers with the Ohio Myeloma Initiative. You can read about this if you CLICK HERE.  Consumer Reports is also looking to provide survival performance by center for all cancers, and this is a potential game changer as well.

The fact that I continue to see progress in the area of survival outcome based performance by facility bodes well for future improvements in cancer life expectancy. Like a very insightful  mentor of mine once stated: “You can not improve that which you do not measure”. This is no different for cancer treatment, and finally it looks like we are moving in that direction.  

Good luck and may God Bless your Cancer Journey.   For more information on multiple myeloma survival rates and treatments CLICK HERE and you can follow me on twitter at: https://twitter.com/grpetersen1