Predictability of hematopoietic stem cell transplantation rates
Predictability of hematopoietic stem cell transplantation rates
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DOI：
10.3324/haematol.11260
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发表时间：
2007-11-30
期刊：
影响因子：
10.1
通讯作者：
Frauendorfer, Karl
中科院分区：
文献类型：
--
作者：
Gratwohl, Alois;Baldomero, Helen;Frauendorfer, Karl
背景和目的造血干细胞移植（HSCT）是一种复杂而昂贵的手术.过去使用这一程序的趋势似乎不稳定。关于未来需求的信息是必不可少的卫生保健administrators.Design和MethodsWe分析了移植率的演变，例如每1000万居民的移植数量，在欧洲从1990年到2004年的所有主要疾病类别，并使用人均国民总收入（GNI），团队密度（每1，000万居民团队数）和团队分布（每10，000公里团队数（2）），以衡量参与国经济因素的影响。通过回归分析对趋势进行了比较，并根据世界银行的定义将各国分为高、中、低收入类别。（R-2=0.72），并且在自体HSCT的狭窄变化窗口内与世界银行类别不同当排除乳腺癌（自体）和慢性髓性白血病（同种异体）时，高、中、低收入类别的R-2分别为0.95、0.98和0.94）和同种异体HSCT（高、中、低收入类别的R-2分别为0.99、0.96和0.95）。团队密度（R-2=0.72）和团队分布（R-2 =0.51）也与transplant rates.Interpretation and ConclusionsTransplant rates for HSCT in Europe是高度可预测的。它们主要受人均国民总收入的影响。不饱和和几乎线性的趋势表明，基础设施落后于医疗需求。单个疾病实体的孤立变化很容易识别。
Background and ObjectivesHematopoietic stem cell transplantation (HSCT) is a complex and expensive procedure. Trends in the use of this procedure have appeared erratic in the past. Information on future needs is essential for health care administrators.Design and MethodsWe analyzed the evolution of transplant rates, e.g. numbers of transplants per 10 million inhabitants, in Europe from 1990 to 2004 for all major disease categories and used Gross National Income (GNI) per capita, team density (numbers of teams per 10 million inhabitants) and team distribution (numbers of teams per 10,000 km(2)) to measure the impact of economic factors in participating countries. Trends were compared by regression analyses, and countries were grouped by World Bank definitions into high, middle and low income categories.ResultsTransplant rates increased over time with nearly linear trends, in clear association with GNI per capita (R-2=0.72), and distinct by World Bank category within a narrow window of variation for both autologous HSCT (R-2 =0.95, 0.98 and 0.94 for high, middle and low income categories, respectively) and allogeneic HSCT (R-2=0.99, 0.96 and 0.95 for high, middle and low income categories, respectively) when breast cancer (autologous) and chronic myeloid leukemia (allogeneic) were excluded. Team density (R-2=0.72) and team distribution (R-2 =0.51) were also associated with transplant rates.Interpretation and ConclusionsTransplant rates for HSCT in Europe are highly predictable. They are primarily influenced by GNI per capita. The absence of saturation and a nearly linear trend indicate that infrastructure lags behind medical needs. Isolated changes in single disease entities can easily be recognized.