Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

A decade of refinements in transplantation improves long-term survival of blood cancers

25.11.2010
A decade of refinements in marrow and stem cell transplantation to treat blood cancers significantly reduced the risk of treatment-related complications and death, according to an institutional self-analysis of transplant-patient outcomes conducted at Fred Hutchinson Cancer Research Center.

Among the major findings of the study, which compared transplant-patient outcomes in the mid-'90s with those a decade later: After adjusting for factors known to be associated with outcome, the researchers observed a statistically significant 60 percent reduction in the risk of death within 200 days of transplant and a 41 percent reduction in the risk of overall mortality at any time after transplant.

"Everything we looked at improved a decade after the initial analysis," said George McDonald, M.D., a Hutchinson Center gastroenterologist and corresponding author of the paper, which was published (date) in the New England Journal of Medicine.

McDonald and colleagues reviewed the outcomes of 1,418 transplant patients who received peripheral-blood stem cells or bone marrow from unrelated donors between 1993 and 1997 and compared them to 1,148 patients who had the same procedures between 2003 and 2007. The malignancies treated included forms of leukemia, lymphoma, multiple myeloma and myelodysplastic syndrome.

The researchers also found that the estimated one-year overall survival rates for both groups were 55 percent and 70 percent, respectively. They also observed statistically significant declines in the risks of severe graft-vs-host-disease; infections caused by viruses, bacteria and fungi; and complications caused by damage to the lungs, kidney and liver.

Lead author and biostatistician Ted Gooley, Ph.D., noted that the analysis presents the findings in terms of the changes in the "risk" or "hazard" of death and transplant complications after taking into account the fact that the patients treated in the mid-2000s were, on average, older and sicker than those who were treated in the mid-1990s.

McDonald said he and his colleagues can only speculate about the reasons for the improved outcomes because the study was retrospective and was not a randomized comparison of transplant techniques and treatments among groups of patients. However, the authors deemed several changes in clinical practices to be important in risk reduction, many of which were the result of ongoing clinical research (including various randomized clinical trials) conducted at the Hutchinson Center and at other major transplant centers around the world:

Careful pharmacologic monitoring and dose adjustments to avoid under and over treatment with the potent chemotherapeutic agents used in transplantation.

Use of reduced-intensity conditioning in older and less healthy patients.

Less use of high-dose systemic immune suppression to treat acute GVHD.
Use of the drug ursodiol to prevent liver complications.
New methods for early detection of viral and fungal infections as well as preventive therapy for such infections.

The use of better and less toxic anti-fungal drugs to treat serious infections caused by Candidal organisms and molds.

Use of donor peripheral blood hematopoietic cells instead of bone marrow as the source of donor cells, which results in faster engraftment and return of immunity.

More accurate matching of marrow or stem cell donors with unrelated patients.
"This research and the improved outcomes are the result of a team approach to one of the most complex procedures in medicine," McDonald said.

Medical oncologists and transplantation biologists at the Hutchinson Center are supported in the care of patients by specialists in infectious diseases, pulmonary and critical care medicine, nephrology, gastroenterology and hepatology, and by highly skilled nurses and support staff.

"Each of these programs is involved in ongoing clinical research into the complications of transplant, which results in constant changes in how transplantation is carried out," he said. "These data show clearly that our collective efforts have improved the chances of long-term survival for our patients."

The study was supported by grants from the National Institutes of Health.

At Fred Hutchinson Cancer Research Center, our interdisciplinary teams of world-renowned scientists and humanitarians work together to prevent, diagnose and treat cancer, HIV/AIDS and other diseases. Our researchers, including three Nobel laureates, bring a relentless pursuit and passion for health, knowledge and hope to their work and to the world. For more information, please visit fhcrc.org.

Christi Loso | EurekAlert!
Further information:
http://www.fhcrc.org

More articles from Health and Medicine:

nachricht Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

nachricht The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Water - as the underlying driver of the Earth’s carbon cycle

17.01.2017 | Earth Sciences

Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

17.01.2017 | Materials Sciences

Smart homes will “LISTEN” to your voice

17.01.2017 | Architecture and Construction

VideoLinks
B2B-VideoLinks
More VideoLinks >>>