Late mortality still a concern despite gains in bone marrow transplant survival, study shows

A UAB study shows that bone marrow transplant recipients have a shorter lifespan as compared to their counterparts.
Written by: Matt Windsor and Tehreem Khan
Media contact: Yvonne Taunton

Smita Bhatia insideA UAB study shows that bone marrow transplant recipients have a shorter lifespan as compared to their counterparts. Research led by the director of the University of Alabama at Birmingham’s Institute for Cancer Outcomes and Survivorship and senior scientist at the O’Neal Comprehensive Cancer Center, Smita Bhatia, M.D., finds that patients who received bone marrow transplantation using their own cells die earlier than their peers.

Bhatia’s study, published in the Journal of Clinical Oncology, found that bone marrow transplant can shorten the lifespan of the receiver by seven years on average; but newer strategies have narrowed the mortality gap.

“These results highlight the need for clinicians to be alert for the development of infections, subsequent cancers, and cardiovascular and renal disease in their patients who have had autologous blood or marrow transplantation in order to further reduce late mortality,” Bhatia said.

The correlation between bone marrow transplant and early death is a growing concern in the United States. An estimate is that, by 2030, the number of patients who have received a bone marrow transplant living in the United States will jump fivefold, to more than 500,000 people.

“The goal of the study is to find predictive traits for cancer survivors who are at higher risk of long-term problems after treatment to help health care providers tailor screenings and other interventions,” Bhatia said.

The researchers studied 4,702 individuals who lived at least two years following an autologous BMT performed between 1981 and 2014. They divided the time into four eras: 1981-1999, 2000-2005, 2006-2010 and 2011-2014.

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Mortality rates five years after transplant declined over those four eras, with the reduction most pronounced among patients who were transplanted for Hodgkin lymphoma or plasma cell dyscrasias. The researchers did not observe a similar decline in mortality rates among patients transplanted for non-Hodgkin lymphoma or those patients conditioned for bone marrow transplant with total-body irradiation. The researchers calculated that patients’ average years of life lost following the transplant declined from five years for the earliest era to 1.6 years for the 2011-2014 time span.

“Years of life lost were greatest for the youngest survivors (5 years old: 16.5 years of life lost) and smallest for the older survivors (70 years old: 0.6 years),” Bhatia said.

Bhatia’s research draws on the Bone Marrow Transplant Survivor Study, which includes more than 10,000 patients treated with bone marrow transplant between 1974 and 2014 at three transplant sites — UAB, the University of Minnesota and City of Hope National Medical Center in California. The study is funded by a $6.38 million grant from the National Cancer Institute.