Center Profile

You can download and print a copy of this form HERE to record your responses for input into the form at a later time. All responses to this survey must be submitted electronically.

Contact Information

Name of Primary Contact:

Center Medical Director:

Center Medical Director's email address:

Administrative Director

Administrative Director's email address

Center Nursing Director:

Center Nursing Director's email address:

Program Information

Medical Center Name:

Medical Center State:

Select number of satellite clinics

CIBMTR center number

Pediatric and/or Adult Program Status

Non-Profit Status/For-Profit Status

Which of the following best describes the facility that operates your transplant program?

If you selected "Other," please explain

Exempt Cancer Center Status

Is Your program affiliated with a teaching hospital?

If Yes, please name the teaching hospital

Is your program designated as a NCI designated cancer center?

If yes, please indicate which designation

Program Affiliations

If you selected "Other," please explain

Donor Collection Center for NMDP or other donor registry

Dedicated Fellowship Program for HSCT and /or IEC

Cell Processing

Cell Processing Laboratory Status

If you selected "Other," please explain

Cell Apheresis

If you selected "Other," please explain

Marrow Collection

If you selected "Other," please explain

Long-term follow-up program dedicated to HSCT and/or IEC

Survivorship program dedicated to HSCT and/or IEC

Clinical Site of Care

Does your program have inpatient beds exclusively dedicated to the care of transplant/cell therapies recipients?

If you selected "Other," please explain

Does your program have an ambulatory setting (clinic, etc.) exclusively dedicated to the care of transplant/cell therapies recipients?

If you selected "Other," please explain

FACT Accreditation Status

Please indicate in which categories your center has achieved FACT Accreditation

Does your state require FACT Accreditation?

Clinical Program - Blood and Marrow Transplant

Clinical Program - Immune Effector Cell

Collection Facility - Marrow

Collection Facility - Apheresis

Product Processing Facility

Scope of Accreditation

Please Provide Comments

Center Volume

Total transplants performed in calendar year 2020

Please indicate volume as applicable

  Adult Pediatric

Autologous

   

Allogeneic - Related

   

Allogeneic - Unrelated

   

Outpatient transplants performed in calendar year 2020

  Adult Pediatric

Autologous

Allogeneic - Related

Allogeneic - Unrelated

Total cellular therapies performed in calendar year 2020

  Adult Pediatric

CAR-T

Other IEC

Collections performed in calendar year 2020 for allogeneic - related transplants

  Adult Pediatric

PBSCs

Marrow

DLI

Collections performed in calendar year 2020 for autologous transplants

  Adult Pediatric

PBSCs

Marrow

Collections performed in calendar year 2020 on behalf of the NMDP or other registry

  Adult Pediatric

PBSCs

Marrow

Cord

DLI

IEC

Collections performed in calendar year 2020 for cellular therapies/IEC:

  Adult Pediatric

Leukopheresis Collections

Peripheral Blood Collection

Other

If you selected "Other," please explain

Clinical FTEs

Clinical Full-Time Equivilencies (FTE) Dedicated to Stem Cell Transplant and Cellular Therapies

NOTE: Divide effort of staff proportionally to volume and workload across any role or across tabs and any individual may not contribute effort greater than 1.0 FTE across all roles

Autologous (AUTO) Stem Cell Transplant

  Adult     Pediatric    
Position/Role Outpatient Inpatient Program/General Outpatient Inpatient Program/General

Physician - AUTO transplant

Advanced Practice Provider (NP/PA) - AUTO

Transplant Nurse Coordinator (RN) Pre-transplant - AUTO

Transplant Nurse Coordinator (RN) Post-transplant - AUTO

Research Nurse (RN) Transplant - AUTO

Transplant Coordinator (non-RN) Pre-transplant - AUTO

Transplant Coordinator (non-RN) Post-transplant - AUTO

Allogeneic (ALLO) Stem Cell Transplant

  Adult     Pediatric    
Position/Role Outpatient Inpatient Program/General Outpatient Inpatient Program/General

Physician - ALLO transplant

Advanced Practice Provider (NP/PA) - ALLO

Transplant Nurse Coordinator (RN) Pre-transplant - ALLO

Transplant Nurse Coordinator (RN) Post-transplant - ALLO

Research Nurse (RN) Transplant - ALLO

Transplant Coordinator (non-RN) Pre-transplant - ALLO

Transplant Coordinator (non-RN) Post-transplant - ALLO

Immune Effector Cell Therapies/CAR-T/Engineered Cell Therapies

  Adult     Pediatric    
Position/Role Outpatient Inpatient Program/General Outpatient Inpatient Program/General

Physician - IEC/CAR-T

Advanced Practice Provider - IEC/CAR-T (NP/PA)

Cell Therapies Nurse Coordinator (RN) Pre-treatment - IEC/CAR-T

Cell Therapies Nurse Coordinator (RN) Post-treatment - IEC/CAR-T

Research Nurse (RN) - IEC/CAR-T

Cell Therapies Coordinator (non-RN) Pre-treatment - IEC/CAR-T

Cell Therapies Coordinator (non-RN) Post-treatment - IEC/CAR-T

Donor Product Apheresis

  Adult     Pediatric    
Position/Role Outpatient Inpatient Program/General Outpatient Inpatient Program/General

Apheresis Center Medical Director

Apheresis Nursing Director

Apheresis Nurse (RN)

Apheresis Technician (non-RN)

Apheresis Site-Based Scheduling and Administrative Support

Marrow Collection

  Adult     Pediatric    
Position/Role Outpatient Inpatient Program/General Outpatient Inpatient Program/General

Physician - Marrow Collection

NP/PA - Marrow Collection

RN - Marrow Collection

Donor Support and Coordination Services -
Report NMDP Donor Center FTEs in Separate Section Below

  Adult     Pediatric    
Position/Role Outpatient Inpatient Program/General Outpatient Inpatient Program/General

Donor Services Medical Director (MD)

Donor Services Director/Administrative Director

Donor Evaluation/Clearance Provider (MD)

Donor Evaluation/Clearance Provider (NP/PA)

Donor Services RN

Donor Services Manager/Supervisor

Donor Search Coordinator/Technician/Search and Selection Specialist (non-RN)

Donor Collection Coordinator for allo transplant or allo CAR-T/IEC (non-RN)

Donor Collection Coordinator for auto transplant or auto CAR-T/IEC (non-RN)

Donor Services Administrative or Scheduling Support

NMDP Donor Center Services

Position/Role Outpatient Inpatient Program/General

NMDP Donor Center Medical Director

NMDP Donor Center Director/Administrative Director

NMDP Donor Center Evaluation/Clearance Provider (MD)

NMDP Donor Center Evaluation/Clearance Provider (NP/PA)

NMDP Donor Center Recruitment

NMDP Donor Center Coordinator (RN)

NMDP Donor Center Coordinator (non-RN)

General

  Adult     Pediatric    
Position/Role Outpatient Inpatient Program/General Outpatient Inpatient Program/General

Physician - consulting specialist (estimate any effort dedicated to transplant or cell therapies)

Oncology Psychologist or Oncology Psychiatrist

Clinical Fellow

Nurse Educator (RN)

Nurse Navigator (RN)

Physical Therapist

Nutrition or Dietary Specialist

Pharmacist (advanced degree)

Pharmacy Technician

Social Worker (BSW)

Social Worker (MSW)

Resource Specialist

Program FTEs

Non-Clinical Full-Time Equivilencies (FTE) Dedicated to Stem Cell Transplant and Cellular Therapies

NOTE: Divide effort of staff proportionally to volume and workload across any role or across tabs and any individual may not contribute effort greater than 1.0 FTE across all roles

Administration and Finance

Position/Role FTE Adult FTE Pediatric Total FTEs Reported are Dedicated to Transplant and Cell Therapies

Administrator (VP, Executive Dir/Administrative Dir/Sr. Dir (with management training)

Center Director (with any clinical training)

Practice Manager

Administrative Support

Business/Financial Manager

Revenue Cycle/Access Manager/Supervisor

Revenue Cycle Access/Financial Counselor

Information Services Systems Administrator/Programmer/Analyst

Quality and Data - AUTO and/or ALLO Transplant

Position/Role FTE Adult FTE Pediatric Total FTEs Reported are Dedicated to Transplant and Cell Therapies

Quality Director/Regulatory Officer

Quality Assurance Manager

Quality Assurance/Improvement/Control Specialist

Outcomes Data Analyst/Data Quality Control Analyst

Outcomes Data Specialist (clinically trained)

Outcomes Data Specialist (non-clinical training)

Quality and Data - CAR-T and other IEC

Position/Role FTE Adult FTE Pediatric Total FTEs Reported are Dedicated to Transplant and Cell Therapies

Quality Director/Regulatory Officer - IEC/CAR-T

Quality Assurance Manager - IEC/CAR-T

Quality Assurance/Improvement/Control Specialist - IEC/CAR-T

Outcomes Data Analyst/Data Quality Control Analyst - IEC/CAR-T

Outcomes Data Specialist (clinically trained) - IEC/CAR-T

Outcomes Data Specialist (non-clinical training) - IEC/CAR-T

Clinical Trials Support Personnel - auto/allo transplantation

Position/Role FTE Adult FTE Pediatric Total FTEs Reported are Dedicated to Transplant and Cell Therapies

Clinical Trials Manager – auto/allo transplantation

Clinical Trials/Research Coordinator - auto/allo transplantation

Clinical Trials/Research Data Specialist - auto/allo transplantation

Clinical Trials/Research Regulatory Specialist - auto/allo transplantation

Clinical Trials/Research Assistant - auto/allo transplantation

Clinical Trials Support Personnel - IEC/CAR-T Program

Position/Role FTE Adult FTE Pediatric Total FTEs Reported are Dedicated to Transplant and Cell Therapies

Clinical Trials Manager – IEC/CAR-T

Clinical Trials/Research Coordinator - IEC/CAR-T

Clinical Trials/Research Data Specialist - IEC/CAR-T

Clinical Trials/Research Regulatory Specialist - IEC/CAR-T

Clinical Trials/Research Assistant - IEC/CAR-T

Cell Processing and Product Manufacturing FTEs

Cell Processing Laboratory/Facility Full-Time Equivilencies (FTE) Dedicated to Stem Cell Transplant and Cellular Therapies

Does your center process cellular products at a separate laboratory under contract?      

If yes, please list the name of the contract laboratory below

Name of Contract Laboratory:

If your center processes and manufactures products on-site, please complete the following two sections

NOTE: Divide effort of staff proportionally to volume and workload across any role or across tabs and any individual may not contribute effort greater than 1.0 FTE across all roles

 

Indicate FTEs

Personnel

Position/Role Minimal 361 products manufactured on site More Than Minimal (351) manufactured on site Licensed products (cords, etc) manufactured on site Handling products manufactured off site Contract work for 351 product development Program/General

Laboratory Director/Associate Director/Assistant Director (MD/PhD)

Laboratory VP/Administrative Director/Director (technical training)

Laboratory Business Manager

Laboratory Technical Director/Manager/Technician Supervisor

Laboratory Cell Processing Technician

Laboratory Quality Assurance Director/Manager

Laboratory Quality Assurance Specialist / Regulatory

Laboratory Quality Control Manager

Laboratory Quality Control Specialist

Laboratory Administrative Support

IT Support

Materials/Supplies Support

Lab assistants / Biomedical Tech

 
 

Indicate Product Volume

Products

Minimal 361 products manufactured on site More Than Minimal (351) manufactured on site Licensed products (cords, etc) manufactured on site Handling products manufactured off site Contract work for 351 product development Other

HPCs

DLI & Tregs

Genetically Modified HPCs

MSCs

IECs

Ca Vaccines

Regenerative

iPSC cell line development

NK cell banks

Other product(s) - please specify

Enter Description

Other product(s) - please specify

Enter Description

Other product(s) - please specify

Enter Description

Other product(s) - please specify

Enter Description

Yescarta handling - Manufactured off-site

Tecartus handling - Manufactured off-site

Kymriah handling - Manufactured off-site

Provenge handling - Manufactured off-site

Other - Manufactured off-site

Enter Description

Other - Manufactured off-site

Enter Description

Other - Manufactured off-site

Enter Description

Other - Manufactured off-site

Enter Description

 
Submit and other info

You can download and print a copy of this form HERE.

The information submitted in this survey will be used only to gain a better understanding of staffing models at cellular therapy/BMT transplant institutions across the United States. The data will be anonymized and will not be identifiable in any future publications. Any personal information that could identify your institution will be removed or changed before files are shared with others. By completing this survey, you do agree to share your submission data with other participants of the survey.