Hematopoietic cell transplantation (HCT) offers a second chance at life for thousands of patients across the country every year — and at City of Hope, that second chance is second to none, according to the National Marrow Donor Program (NMDP).

Patients who underwent unrelated donor HCT at City of Hope have significantly better outcomes than expected under national standards, according to a report recently released by the NMDP. City of Hope has received the organization’s “above expectations” rating in one-year overall patient survivorship for the past five years.

Auayporn P. Nademanee (Photo by Bill Rich)

“City of Hope is the only transplant program to achieve five consecutive years of above-average survival outcome based on the NMDP report of center-specific survival outcomes,” said Auayporn P. Nademanee, M.D., associate clinical director of City of Hope’s Department of Hematology & Hematopoietic Cell Transplantation and director of the Matched Unrelated Donor Program. “This is especially significant because we are also treating sicker patients, older patients and patients with less than perfect matched unrelated donors than most other large transplant programs in the country.”

Nademanee attributed the program’s success to its team approach to treatment, pulling in expertise from all areas, such as David Senitzer, Ph.D., director of the Histocompatibility Laboratory. The lab conducts molecular typing for donor selection to determine which genetic matches are crucial for the best outcomes. They also find which mismatches are acceptable, so they can expand the pool of potential donors.

“Everyone involved in the transplant program is dedicated to delivering the best patient care and advancing our understanding of hematopoietic cells to improve treatment options for patients,” Nademanee said. “Our nurses have years of experience in helping patients through the transplant experience. Our search coordinators devote so much to finding potential donors. Our specialists in pulmonology, infectious diseases and other areas also have so much experience in caring for transplant patients. We all work together as a team with the shared mission of caring for patients.”

The NMDP helps physicians and their patients find potential bone marrow and umbilical cord blood donors through its “Be The Match” registry and other registries around the world. About 40 percent of City of Hope patients who undergo HCT rely on these unrelated donors for their transplants, Nademanee said.

Every year, the NMDP compares one-year overall survival rates among patients who receive unrelated HCT donations through its program. Its latest report includes an analysis of 125 transplant centers that performed at least one HCT from 2003 through the end of 2007.

NMDP establishes a predicted survival rate for each center based on patients’ risk factors. The center’s actual patient survival rate is compared to the predicted rate to determine whether a center is performing below, at or above expectations.

The relative risk of a center’s patient population includes factors such as age, disease, disease stage and HLA matching. Risk level ranges from 1 (low risk) to 5 (high risk).

City of Hope is one of only 10 transplant centers in the report that performed more than 200 transplants annually, and only three of these centers, including City of Hope, performed above expectations. City of Hope’s patient population is rated at 4 (medium-high risk), while the other two centers are rated at 3 (medium risk).

The national one-year survival rate among the nearly 9,700 patients transplanted in the U.S. was 56.3 percent. City of Hope’s actual survival rate was 64 percent, much higher than the 53 percent predicted survival rate for a medium-high risk patient population.

The other two centers that performed above expectations treated lower-risk patients.

“Our excellent history of patient outcomes is a result of the great support system we have in place,” said Stephen J. Forman, M.D., the Francis and Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation and chair, of the Department of Hematology & Hematopoietic Cell Transplantation. “Everyone works together — physicians, scientists, nurses, pharmacists, technicians and staff. We have outstanding unrelated-donor search coordinators who have expertise in the donor search process.”

City of Hope has performed more than 9,980 transplant procedures since 1976, when it achieved one of the first successful bone marrow transplants in the nation.

City of Hope’s full profile is available online at www.marrow.org. From the Patients & Families tab, select Transplant Planning, then select Choosing a Transplant Center. The “U.S. NMDP transplant centers” link provides a list of centers by state.