Acute leukemias and myelodysplastic syndromes (MDS) are the most common diagnoses treated with unrelated donor bone marrow or umbilical cord blood transplants (also called hematopoietic cell transplants).
More leukemia patients receiving transplants
Figure 1 below shows that the number of unrelated donor transplants the National Marrow Donor Program® (NMDP) has facilitated for acute myelogenous leukemia (AML), as well as other diagnoses, has increased significantly in the past five years.
Figure 1.
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This increase is the result of advances in treatment enabled by research. The most dramatic growth has been for patients with AML. A major reason for this growth is the use of non-myeloablative or reduced-intensity transplants. (These transplants use less intense pre-transplant conditioning regimens than the standard high-dose chemotherapy and/or radiation therapy.)
AML is mainly a disease of older adults, but until recently many older patients were not eligible for transplantation because it was believed they might not tolerate the intense pre-transplant chemotherapy traditionally used to prepare the body to receive donated cells. The introduction of reduced-intensity regimens has now expanded transplantation to older patients who previously would have been excluded.
Recent studies
Two recent studies illustrate how investigations into pre-transplant regimens and donor-patient matching are enabling more patients to receive transplants today.
Extending transplantation to older patients with MDS or AML
Recent studies continue to advance reduced-intensity transplants as a treatment option and extend its use in medical practice. A 2010 study of reduced-intensity transplants in 1,080 adults aged 40-79 with MDS or AML during their first complete remission showed that transplants using reduced-intensity conditioning have similar results to transplants using traditional high-dose conditioning.
The researchers concluded that "older age alone should not be considered a contraindication to HCT" (hematopoietic cell transplantation). [1]
Reducing relapse rates in AML
By examining more than 1,000 donor-recipient samples from the NMDP Research Sample Repository, researchers discovered that transplants using donors with a specific genetic characteristic cut the rate of relapse by two thirds.
In this study of patients with AML, transplants using donors who had a specific combination of genetic markers called a B/B KIR haplotype had relapse rates of only 10%. In comparison, relapse rates were 31% for patients whose donors had other KIR types. [2]
One way your funding helps
Be The Match Foundation® understands investing in cutting-edge research is critical to serving more patients in need of a transplant. Funding clinical and observational studies is costly. But the data gleaned from in-depth patient tracking is so vital to refining therapies, improving survival rates and discovering the next generation of transplant care that your funds are needed here.
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Information for patients and families
To learn more about disease symptoms, diagnosis and treatment options, see information for patients about acute myelogenous leukemia, myelodysplastic syndromes and other diseases treatable with transplant.
Updates on current transplant research
References
- McClune BL, Weisdorf DJ, Pedersen TL, et al. Effect of age on outcome of reduced-intensity hematopoietic cell transplantation for older patients with acute myeloid leukemia in first complete remission or with myelodysplastic syndrome. J Clin Oncol. 2010; 28(11):1878-1887.
http://jco.ascopubs.org/cgi/content/abstract/28/11/1878
- Cooley S, Weisdorf DJ, Guethlein LA, et al. Donor selection for natural killer cell receptor genes leads to superior survival after unrelated transplantation for acute myelogenous leukemia. Blood. 2010; Published online June 25.
http://dx.doi.org/10.1182/blood-2010-05-283051