A new study from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation reports that in Europe, socioeconomic factors have a direct correlation to the rates and outcomes of stem cell transplantation for patients with acute myeloid leukemia (AML). This study was published online today in Blood, the official journal of the American Society of Hematology.
“Stem cell transplantation is an expensive procedure requiring well-equipped transplant units; advanced, long-term supportive care; and highly qualified medical and nursing staff, so it may be expected that access to these transplants as well as outcome of the procedure would depend on socioeconomic factors varying among and within countries,” said lead study author Sebastian Giebel, MD, of the Department of Clinical and Experimental Oncology at the Comprehensive Cancer Center of the Maria Sklowdowska-Curie Memorial Institute in Gliwice, Poland.
In this study, a team of researchers led by Dr. Giebel evaluated the association of the Human Development Index (HDI) with rates and outcomes (both short- and long-term) of AML patients treated with hematopoietic stem cell transplantation (HSCT). Using data on 16,403 patients from 30 European countries between 2001-2005, the team compared socioeconomic status with HSCT procedure rates. They then analyzed long-term outcomes (primarily leukemia-free survival, or LFS) related to HSCT for a sub-group of 2,015 AML patients who had received an HLA-matched allogeneic (using donor cells rather than one’s own cells) HSCT.
The HDI is used by the United Nations to measure the socioeconomic status of countries across three basic categories: longevity (expressed as a life expectancy index, or LEI), knowledge (expressed as education index, or EI) and standard of living (measured by gross domestic product index, or GDPI). Based on the HDI, countries are considered to have a low, intermediate, or high development status. Most European states fall into the “high” category, but there are some variations so, for the purpose of this study, countries were categorized into five distinct HDI ranges.
Results of the study found that in Europe, the HDI was associated with both rates and results of HSCT for acute leukemia, with the strongest association related to the few countries in the highest HDI group (eight countries). With regard to rates of HSCT procedures, the team found significant correlations between HDI and total HSCTs performed for AML patients. The strongest associations were found between transplant rates and scores related specifically to LEI and GDPI, suggesting that not only purely economic conditions, but also the organization of the health-care and educational systems likely translate into availability of HSCT.
With regard to patient outcomes, transplants performed in countries in the highest HDI group were associated with significantly higher LFS (68%), which resulted mainly from reduced risk of relapse, as compared with the other four HDI groups (56%, 59%, 63%, and 58%, respectively, in order of increasing HDI score).
“We believe there is still room for improvement in most European states to reach the outcomes achieved by the highest-HDI states, and identifying the factors that contribute to these differences is critical,” said Dr. Giebel. “Our study was retrospective in nature, so we would encourage further prospective studies with detailed patient and procedural characteristics to help understand the true differences and design interventions to improve outcomes worldwide.”
Previous studies have demonstrated some association of socioeconomic status (SES) with access to HSCT and mortality after transplantation in other parts of the world, but the association had not previously been studied across Europe, where diversity of SES may be less pronounced and most countries are considered well-developed. However, differences remain with regard to standard of living, education, and organization of health care, which may be reflected in the variations in HDI. Variable factors suggested by the study authors may include compliance with chemotherapy protocol, health insurance coverage, educational status, and availability of care.
Reporters who wish to receive a copy of the study or arrange an interview with Dr. Giebel may contact Patrick Irelan at 202-776-0544 or firstname.lastname@example.org.
The American Society of Hematology (www.hematology.org) is the world’s largest professional society concerned with the causes and treatment of blood disorders. Its mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems, by promoting research, clinical care, education, training, and advocacy in hematology. ASH provides Blood: The Vital Connection (www.bloodthevitalconnection.org), a credible online resource addressing bleeding and clotting disorders, anemia, and cancer. The official journal of ASH is Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, which is available weekly in print and online.
Patrick C. Irelan | EurekAlert!
How brains surrender to sleep
23.06.2017 | IMP - Forschungsinstitut für Molekulare Pathologie GmbH
A new technique isolates neuronal activity during memory consolidation
22.06.2017 | Spanish National Research Council (CSIC)
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
23.06.2017 | Physics and Astronomy
23.06.2017 | Physics and Astronomy
23.06.2017 | Information Technology