December 12, 2011

Stem Cell Transplant Recipients Prone to Problems

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Joseph V. Madia, MD By:

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Hematopoietic Cell Transplantation patients at higher risk of psychological or chronic health issues

(dailyRx News) Stem cell transplant patients may not only be at risk during treatment. A new study suggests that a decade later they are still more susceptible to psychological conditions and chronic illness.

More than 15 years later, 71 percent of Hematopoietic Cell Transplantation (HCT) patients reported development of a chronic illness, and 40 percent had suffered from a severe life-threatening condition or had died.

"Coordinate care with your physician after a transplant."

The stem cells are usually derived from bone marrow, blood stem cells or umbilical cord blood, often to treat patients with conditions including leukemia, Hodgkin's disease, sickle cell anemia and aplastic anemia.

Dr. Smita Bhatia, a study author and professor at City of Hope, a California cancer center, said she observed that HCT patients were more likely to report chronic health conditions as compared to their siblings. She urged awareness for patients, family members and health care providers of the higher burden of care for HCT survivors so they can adequately plan care following the transplant.

A previous study suggested that morbidity may increase with time after HCT, but little research had been available regarding long-term survivors.

Researchers said the long-term complications in patients who had received the stem cell transplants may have been increased by high intensity therapies such as chemotherapy -- either from the radiation itself or from suppressing the immune system in preparation for the transplant.

During the study researchers enrolled 366 HCT survivors and 309 siblings between the ages of 11 and 72 through the Bone Marrow Transplant Study, assigning severity scores to any illnesses or conditions they may have developed.

In addition, investigators examined the amount of healthcare use by the participants.

A symptom inventory was used to evaluate psychological health. Patients were followed for a mean of 15 years.

Of the HCT survivors, 74 percent reported at least one chronic health condition versus 29 percent for siblings. An additional 25 percent of transplant patients suffered from a severe or life-threatening condition as compared to 8 percent of siblings.

The most common chronic conditions reported included heart attack, stroke, diabetes, blindness and musculoskeletal problems. The results were especially intriguing because for 65 percent of participants, the stem cell donor had been their sibling.

Survivors also were 5.6 times more likely to develop a severe condition compared to siblings matched by age and gender. Transplant recipients also were 2.7 times more likely to report somatic distress.

Patients found to be at an increased risk of somatic distress included women, those from a low-income household and patients who self-reported a "poor" health status.

The research was presented on Saturday at the American Society of Hematology's annual meeting in San Diego, Calif.

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Reviewed by: 
Joseph V. Madia, MD
Review Date: 
December 10, 2011

Last Updated:
December 12, 2011