Medical Education

November 2011 View as a webpage | Forward to a colleague | Not subscribed? Subscribe here
Advances in Transplantation
Featured Articles

Non-myeloablative HCT outcomes in older patients

A long-term, multi-center study has shown that non-myeloablative hematopoietic cell transplantation (HCT) in older patients with advanced hematologic malignancies can lead to a 5-year overall survival of 35%. Median age of patients was 64.1 years (range: 60.1-75.1), and pre-transplant conditioning was low-dose total body irradiation and/or fludarabine at 90mg/m2. Graft sources were related (n=184) and unrelated (n=188) donors. In multivariate analyses, higher HCT-specific comorbidity index scores were significantly associated with worse outcomes, but there was no association between increasing age and organ toxicities, or acute or chronic GVHD.

Sorror ML, et al. JAMA »

Accompanying editorial: Mineishi S, JAMA »

Psychological outcomes in long-term survivors of HCT

A study from the Bone Marrow Transplant Survivor Study has identified two risk factors for long-term psychological distress in transplant recipients: a self-assessment of fair or poor health status, and receiving prednisone. The study compared 1065 transplant recipients with a healthy control group of siblings, and found that 22% of transplant recipients self-reported adverse psychological outcomes, compared with 8% of sibling controls. In addition, economically disadvantaged transplant recipients (household annual income ≤$60,000/year) had a higher risk of psychological distress. The researchers concluded that while some subpopulations of transplant recipients may need psychological interventions, the majority of long-term transplant survivors are not at risk for clinical levels of anxiety and depression.

Sun C-L, et al. Blood »

Accompanying editorial: Bevans M, Blood »

Improved HCT survival over time

A long-term study of 953 hematopoietic cell transplants (HCT) between 1992 and 2009 at Karolinska University Hospital, Stockholm, has demonstrated significant improvements over time in overall survival and transplant-related mortality (TRM), including a 100-day TRM of 5.5% in the most recent time period (2006-2009). The researchers noted that these improvements over time came despite HCT being currently used to treat older patients with more advanced disease. However, the researchers also concluded that the “problem of relapse still has to be remedied,” because the study found that the incidence of relapse has not changed since 1992, ranging from 22% to 25%.

Remberger M, et al. Biol Blood Marrow Transplant »

Risk factors for acute GVHD and survival after HCT

A study of 5561 adults transplanted between 1999-2005 has identified risk factors for acute graft-versus-host disease (GVHD), overall survival, and transplant-related mortality. Transplant outcomes were reported to CIBMTR (Center for International Blood and Marrow Transplant Research), and used HLA-identical sibling donors (n=3191) or unrelated donors (n=2370). Multivariate analyses evaluated six different conditioning regimens/GVHD prophylaxis combinations and their effect on acute GVHD. In both related and unrelated donor cohorts, tacrolimus plus methotrexate-based GVHD prophylaxis was significantly associated with lower odds of grades B-D acute GVHD: Odds Ratio (OR) 0.65, 95% CI 0.53-0.80, p<0.0001 (related donor); and OR 0.79, 95% CI 0.67-0.94, p=0.008 (unrelated donor).

Jagasia M, et al. Blood »

Report: Long-term organ damage and dysfunction after pediatric HCT

This report from a consensus conference convened by the National Cancer Institute and the National Heart, Lung and Blood Institute describes the current understanding of the pathophysiology of late post-transplant effects involving the gastrointestinal, renal, cardiac, and pulmonary systems in pediatric HCT recipients. The report examines how underlying diseases, pre-transplantation exposures, conditioning regimens, and other aspects of HCT can affect these systems, and discusses ways to identify patients at greatest risk for adverse outcomes.

Nieder ML, et al. Biol Blood Marrow Transplant »


Register for the NMDP Satellite Symposium at ASH

Reserve your spot at the upcoming CME activity: Recent Advances in Hematopoietic Cell Transplantation: Evidence-Based Decision-making, the NMDP-sponsored symposium preceding the American Society of Hematology (ASH) Annual Meeting. Friday, December 9, 2011, 7:00 a.m. - 11:00 a.m., San Diego Convention Center - Upper level, Room 20AB.

Register »

NMDP Marks 50,000 Transplants by Recognizing Researchers at ASH

In special recognition of the critical role research has had in advancing the field of hematopoietic cell transplantation, the NMDP is awarding $25,000 total to the highest-scoring abstracts in 10 categories at the 2011 ASH Annual Meeting. Leave a congratulatory message for the award winners in the NMDP booth #1621.

CME: Management of Advanced Non-Hodgkin Lymphomas

A new NMDP-sponsored CME series is now available: Management of Advanced Non-Hodgkin Lymphomas. This four-part series reviews treatment options for follicular, mantle cell, diffuse large B-cell, and T-cell lymphomas. Learn about first- and second-line treatment options for relapsed/refractory patients, including novel agents, and both allogeneic and autologous transplantation.

Access NHL CME program »

Test Your Knowledge

Between 2006 and 2010, the number of NMDP transplants for patients >50 has increased by what percentage?

Answer Now
Other Noteworthy Articles
WMDA guidelines for subsequent stem cell donations

Access abstract »

Racial disparities in HCT in the U.S.

Access abstract »

Role of anti-HLA antibodies in HCT

Access abstract »

Resources for You
Numbers Count

View highlights of key transplant advances, and access the references and outcomes data behind the numbers.
View video »

Resources For Your Patients
for children:
Super Sam vs. the Marrow Monsters

This video helps children and families understand the transplant journey. Includes tips, activity sheets and more. View video »

NMDP Website

Access more clinical and patient resources on our website.

Otsuka Pharmaceuticals

Supported by an unrestricted educational grant from Otsuka America Pharmaceutical, Inc., provided to the National Marrow Donor Program through the Be The Match Foundation®, the funding partner of the NMDP.

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