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 email@example.com.
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!
Climate Impact Research in Hannover: Small Plants against Large Waves
17.08.2018 | Leibniz Universität Hannover
First transcription atlas of all wheat genes expands prospects for research and cultivation
17.08.2018 | Leibniz-Institut für Pflanzengenetik und Kulturpflanzenforschung
New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference
Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...
Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...
Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.
When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...
Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.
Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....
Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.
Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...
17.08.2018 | Event News
08.08.2018 | Event News
27.07.2018 | Event News
17.08.2018 | Life Sciences
17.08.2018 | Event News
17.08.2018 | Materials Sciences