Trends in allogeneic hematopoietic cell transplantation survival using population-based descriptive epidemiology method: analysis of national transplant registry data.

in Bone marrow transplantation by Yachiyo Kuwatsuka, Hidemi Ito, Ken Tabuchi, Takaaki Konuma, Naoyuki Uchida, Yoshihiro Inamoto, Kazuki Inai, Tetsuya Nishida, Kazuhiro Ikegame, Tetsuya Eto, Yuta Katayama, Keisuke Kataoka, Masatsugu Tanaka, Satoshi Takahashi, Takahiro Fukuda, Tatsuo Ichinohe, Fumihiko Kimura, Junya Kanda, Yoshiko Atsuta, Keitaro Matsuo

TLDR

  • The study looked at how long people who got a special kind of bone marrow transplant called hematopoietic cell transplantation (HCT) lived. The study used data from a registry in Japan and found that the 10-year survival rate for the entire group was 41.5% for males and 47.4% for females. The study also found that the survival rate varied based on the type of cancer, age, and the source of the donor's cells. The study's findings are important because they provide a benchmark for comparing the survival rates of patients undergoing HCT among different registries and can help doctors and researchers understand how to improve long-term survival for patients undergoing HCT.

Abstract

Prognosis for patients undergoing hematopoietic cell transplantation (HCT) has been improving. Short-term survival information, such as crude survival rates that consider deaths immediately after the transplantation, may not be sufficiently useful for assessing long-term survival. Using the data of the Japanese HCT registry, the net survival rate of patients who survived for a given period was determined according to age, disease, and type of transplant. We included a total of 41,716 patients who received their first allogeneic hematopoietic cell transplantation between 1991 and 2015. For each disease, age group, graft source subcategory, net survival was calculated using the Pohar-Perme method, and 5-year conditional net survival (CS) was calculated. Ten-year net survivals of total patient cohort were 41.5% and 47.4% for males and females, respectively. Except for myelodysplastic syndrome, multiple myeloma, and adult T-cell leukemia/lymphoma, 5-year CS for 5-year transplant survivors exceeded 90%. CS was especially high for aplastic anemia, of which was over 100% for children and younger adults receiving cord blood, suggesting that these patients have similar longevity to an equivalent group from the general population. These findings provide useful information for long-term survival, and can serve as benchmark for comparisons among registries, including other cancers.

Overview

  • The study aims to determine the net survival rate of patients who underwent hematopoietic cell transplantation (HCT) using data from the Japanese HCT registry. The study includes a total of 41,716 patients who received their first allogeneic HCT between 1991 and 2015. The study calculates net survival for each disease, age group, and graft source subcategory using the Pohar-Perme method and 5-year conditional net survival (CS) for 5-year transplant survivors. The study's primary objective is to provide useful information for long-term survival and serve as a benchmark for comparisons among registries, including other cancers.

Comparative Analysis & Findings

  • The study compares the net survival rates of patients undergoing HCT based on age, disease, and graft source subcategory. The study finds that the 10-year net survival of the total patient cohort is 41.5% and 47.4% for males and females, respectively. Except for myelodysplastic syndrome, multiple myeloma, and adult T-cell leukemia/lymphoma, 5-year CS for 5-year transplant survivors exceeds 90%. The study also finds that the CS is especially high for aplastic anemia, with over 100% for children and younger adults receiving cord blood, suggesting that these patients have similar longevity to an equivalent group from the general population. These findings provide useful information for long-term survival and can serve as a benchmark for comparisons among registries, including other cancers.

Implications and Future Directions

  • The study's findings highlight the importance of considering long-term survival when assessing the prognosis of patients undergoing HCT. The study's results can serve as a benchmark for comparisons among registries, including other cancers. The study's findings also suggest that the net survival rate of patients undergoing HCT varies based on age, disease, and graft source subcategory. Future research could explore the factors that influence net survival rate in more detail and develop interventions to improve long-term survival for patients undergoing HCT.
Read Full Article