transplant survival getting better

[tytd]

Here's an abstract to an article just published in May, 2013Journal of Clinical Oncology which indicates that transplant survival is improving and more are being done as we suspected from many on this forum having been through it. I have not read the full article yet but it give us hope that the treatments will continue to improve. These are however still old data up to 2005.not sure what the statistics are from 2005 until 2013----------- Significant Improvement in Survival After Allogeneic Hematopoietic Cell Transplantation During a Period of Significantly Increased Use, Older Recipient Age, and Use of Unrelated Donors
©American Society of Clinical Oncology
Purpose Over the past four decades, allogeneic hematopoietic cell transplantation (alloHCT) has evolved as a curative modality for patients with hematologic diseases. This study describes changes in use, technique, and survival in a population-based cohort.

Patients and Methods The study included 38,060 patients with hematologic malignancies or disorders who underwent first alloHCT in a US or Canadian center from 1994 to 2005 and were reported to the Center for International Blood and Marrow Transplant Research.

Results AlloHCT as treatment for acute lymphoblastic (ALL) and myeloid leukemias (AML), myelodysplastic syndrome (MDS), and Hodgkin and non-Hodgkin lymphomas increased by 45%, from 2,520 to 3,668 patients annually. From 1994 to 2005, use of both peripheral (7% to 65%) and cord blood increased (2% to 10%), whereas use of marrow decreased (90% to 27%). Despite a median age increase from 33 to 40 years and 263% increase in unrelated donors for alloHCT, overall survival (OS) at day 100 significantly improved for patients with AML in first complete remission after myeloablative sibling alloHCT (85% to 94%; P < .001) and unrelated alloHCT (63% to 86%; P < .001); 1-year OS improved among those undergoing unrelated alloHCT (48% to 63%; P = .003) but not among those undergoing sibling alloHCT. Similar results were seen for ALL and MDS. Day-100 OS after cord blood alloHCT improved significantly from 60% to 78% (P < .001) for AML, ALL, MDS, and chronic myeloid leukemia. Use of reduced-intensity regimens increased, yielding OS rates similar to those of myeloablative regimens.

Conclusion Survival for those undergoing alloHCT has significantly improved over time. However, new approaches are needed to further improve 1-year OS.

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[Neil Cuadra]

There are three reasons that the news is even better than this report shows:

1. The data is from a few years back, as you point out. Recent data would contain even better statistics.
   
   
2. As transplant success rates go up, the pool of patients eligible for transplants grows. That's why the median age rose from 33 to 40; older patients are getting transplants. If the ages of patients were still limited as in the past, the measured success rates would be even higher.
   
   
3. For the same reasons, patients with less-ideal health conditions are now undergoing transplants, where in the past the tradeoffs wouldn't have warranted undergoing the risks of a transplant. If the restrictions of the past were still applied today, the measured success rates would be even higher.

[KMac]

This is such wonderful news. Thank you for posting! And thank you Neil for pointing out reasons why the outlook is even better than the article suggests.

I see people at my hospital with aplastic anemia doing very well after transplant. Two in particular, both over 40, neither with a sibling donor, and one with only a 9/10 match.

It seems that despite the risk & uncertainty, improvements in medicine offer us more reasons to be hopeful with every passing year.