Long-term outcomes studied for stem cell transplant recipients
Improved techniques and supportive care have resulted in a growing number of long-term survivors of stem cell transplants, though little is known about the impact transplants have on patients’ lives long after treatment. To find the answers, researchers from the City of Hope Cancer Center and the University of Minnesota assessed 854 cancer patients that had undergone stem cell transplants, taking a detailed look at the aftereffects of the procedure in the years following the transplant. Their results will be published in the June 1, 2005, issue of Blood, the official journal of the American Society of Hematology.
All study patients had survived at least two years post-transplant, with more than 70 percent surviving through the study’s completion. The majority of study deaths occurred within five years of the transplant, but for those who survived past the fifth anniversary of their transplant, the risk of death lessened each year thereafter. Only eight deaths were recorded for those who underwent a transplant 10 years prior, and none were recorded after 15 years. In fact, for some patients – including those who had a transplant for acute myeloid leukemia and all patients with any disease who had a standard risk (as opposed to high risk) of relapse at the time of transplantation – mortality at the 10-year mark was similar to that of the general population.
Further analysis highlighted the most likely causes for death in those patients that did not survive and hinted at ways that such deaths might be minimized. For those patients who died during the study period, the main cause was a recurrence of the original disease, followed by deaths due to secondary cancers. Relapse-related mortality was increased among patients with Hodgkin’s disease, non-Hodgkin’s lymphoma, and acute lymphoblastic leukemia. However, those who had undergone total body irradiation in preparation for the transplant were at a decreased risk for relapse-related death. Mortality not related to relapse was increased in patients who had received the chemotherapy drug carmustine as part of their preparative regimen and among patients who had received a transplant with peripheral blood stem cells, as opposed to stem cells from the bone marrow.
In addition to survival, the researchers wanted to study the quality of life patients had after transplant. To that end, 374 patients from the original group also participated in a follow-up survey investigating issues such as marital status, insurance coverage, education, income, and employment. For comparison, siblings of the participants completed the same questionnaire. The researchers found that the transplant survivors were more likely to report a health problem preventing them from holding a job when compared to the sibling group, especially the older survivors. Transplant participants were also more likely to report difficulty in obtaining or retaining health or life insurance (around 30 percent versus 5 percent). Other factors studied were at a level comparable to the non-transplanted counterparts.
"The results of this study will have a great impact on predicting long-term outcomes for the thousands of patients who receive stem cell transplants every year," said Smita Bhatia, M.D., M.P.H., a staff physician at the City of Hope Cancer Center and lead author of the study. "This sets the stage for the study of interventions that could decrease patient deaths years after treatment. For those most at risk, perhaps better therapeutic options are needed."
This work was supported in part by R01 CA078938 from the National Cancer Institute as well as The Leukemia & Lymphoma Society Clinical Scholar Award 2191-02.
: Laura Stark | EurekAlert!
The most recent press releases about innovation >>>
Die letzten 5 Focus-News des innovations-reports im Überblick:
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
New technique promises tunable laser devices
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...