Practices Vary Among Cell Transplant Physicians

April 3, 2008

Transplant practices vary worldwide among both pediatric and adult hematopoietic cell transplantation physicians, suggesting the need for clinical trials or observational data to guide the best practice, according to the results of a study published online March 31 in the Journal of Clinical Oncology.

THURSDAY, April 3 (HealthDay News) -- Transplant practices vary worldwide among both pediatric and adult hematopoietic cell transplantation physicians, suggesting the need for clinical trials or observational data to guide the best practice, according to the results of a study published online March 31 in the Journal of Clinical Oncology.

Stephanie J. Lee, M.D., from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues conducted an international Internet survey of 526 adult and pediatric hematopoietic cell transplantation physicians, consisting of various clinical scenarios to examine their medical decision making.

The researchers found that there was substantial practice variation, with adult and pediatric transplant physicians differing in their management of chronic myeloid leukemia, acute and chronic graft-versus-host disease, and graft source for patients with aplastic anemia. Adult transplant physicians differed on which patient factors favored reduced intensity conditioning or myeloablative conditioning. Pediatric physicians differed on treatments for low- and high-risk acute myelogenous leukemia.

"These results emphasize the heterogeneity of worldwide transplant practices," Lee and colleagues conclude. "Local preferences or biases likely result in similar patients being offered different transplant and treatment procedures."

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