A recent study suggests that patients who receive a bone marrow transplant for certain conditions are probably cured if they remain disease-free for two years.
"However, for many years after transplantation, the mortality among these patients is higher than that in a normal population," Gérard Socié, MD, PhD, and colleagues wrote on July 1 in The New England Journal of Medicine (1999;341:14-21).
The authors analyzed the records of 6,691 patients listed in the International Bone Marrow Transplant Registry who had their transplants between January 1980 and December 1993 at 221 transplant centers around the world. The patients had undergone their transplants for acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, or aplastic anemia, and all of them were free of their original disease two years after transplantation.
The probability of surviving for five more years was 89%, and the probability of new cancer appearing seven years after transplantation was 2%. Among patients who had had aplastic anemia, "the risk of death by the sixth year after transplantation did not differ significantly from that of a normal population," the authors wrote. However, mortality was significantly higher than normal among patients who underwent bone marrow transplantation for leukemia.
An accompanying editorial by E. Donnall Thomas, MD, of Fred Hutchinson Cancer Research Center in Seattle noted that "it is clear that marrow transplantation does not confer a normal life span. However, the slightly increased risk of death with the passage of the years may not be so bad when one considers the alternative" (1999;341:50-51).
The authors of the study were reporting for the Late Effects Working Committee of the International Bone Marrow Transplant Registry.
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