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Study Finds Overall Health and Quality of Life Intact 10 Years
after Transplant
Ten-year adult survivors of a bone marrow or blood stem cell
transplant can expect to be just about as healthy as adults who have never had
a transplant, according to a new study by researchers at Fred Hutchinson Cancer
Research Center in Seattle.
The study, published in the Sept. 20 edition of the Journal of
Clinical Oncology¹, is the first of its kind to follow a large group of
patients from before their transplant through the 10-year post-transplant
period.
"In many areas of health, our survivors are undistinguishable from
case-matched controls who participated in this study and had not had a
transplant," said lead investigator Karen Syrjala, Ph.D., head of the
Biobehavorial Sciences group in the Hutchinson Center's Clinical Research
Division.
The study found that transplant survivors and case-matched
controls reported similar rates of hospitalization and outpatient medical
visits. They had similar rates of diseases and conditions such as asthma,
diabetes, high blood pressure, high cholesterol, osteoporosis and
hypothyroidism, and they had similar psychological health, marital satisfaction
and employment.
However, the study also found that transplant patients had a
higher incidence of musculoskeletal problems, such as stiffness and cramping;
poor long-term sexual health; and increased urinary frequency and leaking than
the control group. Long-term survivors also had higher usage rates of
anti-depressant and anti-anxiety medications even though reported rates of
depression and anxiety were about the same as those of the control group.
"Adults 10 years after transplant look very healthy and 'normal,'
" says Syrjala. "At the same time, they have more health problems that are not
life-threatening than adults who did not have transplants. In some ways, they
have the health problems of aging somewhat earlier than we would expect by
their age alone. For this reason, we believe that patients need to advocate for
and physicians need to consider asking about and testing for diseases like
osteoporosis, thyroid dysfunction, musculoskeletal aches and pains, sexual
problems and urinary leaking that they might normally only consider in older
adults."
The study included 137 transplant survivors who were transplanted
at the Hutchinson Center between March 1987 and March 1990, and an equal number
of controls. The median age at time of transplant was 36.4 years. Most of those
surveyed had been treated for leukemia or lymphoma. More than three-quarters
received donor cells from a matched relative. There was an almost equal split
between males and females.
The study is important because information on 10-year survivorship
has been sparse. "Although research on late effects has increased, systematic
information has not been available to guide oncologists or primary care
physicians in routine monitoring and management of health-care needs after 10
years in this population," says Syrjala. "We hope to continue following these
survivors to find out whether they remain generally healthy 15 to 20 years
after transplant or whether some of the concerns we identified become more
evident as problems."
¹Syrjala, K.L, Langer, S.L, Abrams, J.R,
Storer, B.E, Martin, P.J.; Late Effects of Hematopoietic Cell Transplantation
Among 10-year Adult Survivors Com-pared with Case-Matched Controls. |
