Blood Cell Transplants Boost Survival

Blood cell transplants give a better chance of survival to many patients with leukemia and other blood cancers than do bone marrow transplants, a study found. <br><br>About a third of transplants done

Friday, January 19th 2001, 12:00 am

By: News On 6

Blood cell transplants give a better chance of survival to many patients with leukemia and other blood cancers than do bone marrow transplants, a study found.

About a third of transplants done on victims of bloodstream cancer use the blood cell technique, which has been widely performed for only about five years.

Cancer specialists agreed that bone marrow transplants will remain an important option for many patients. But they said use of the blood cell technique is apt to expand because of the latest research, which was the biggest and most sophisticated study yet on this form of transplantation.

``The substantial survival advantage in patients with advanced disease leads one to think that this is how they should be treated,'' said Dr. Mary Horowitz, scientific director of the International Bone Marrow Transplant Registry in Milwaukee. ``This clinches the case.''

The findings were published in Thursday's New England Journal of Medicine.

In the study of 172 patients at the Fred Hutchinson Cancer Research Center in Seattle, blood cell transplants restored a patient's infection-fighting white cells in an average of 16 days, compared with 21 days for bone marrow transplants.

The overall survival rate at two years was 66 percent for patients with blood transplants and 54 percent with marrow. The advantage was especially dramatic for the most advanced cancer cases: 57 percent to 33 percent.

``It's better than we expected. We didn't anticipate there would be any survival advantage,'' said Dr. William Bensinger who led the study at the Hutchinson Center.

Marrow or blood cell transplants are needed to regenerate a patient's blood and immune system after chemotherapy or radiation, which curb cancer but weaken the body's ability to restore blood.

Both procedures use stem cells, immature bodies that can develop into various kinds of mature blood cells. But the marrow transplants extract them from a donor's spine with dozens of needle pricks in a procedure that requires anesthesia.

With so-called peripheral blood cell transplants, just two needles are used, normally in donors' arms. The donor takes injections of a hormone for several days to boost blood cell production. Stem cells are then collected from the donor's blood as it is circulated through a machine.

More than half of the patients studied suffered from moderate-to-severe graft-versus-host disease, in which the new blood begins to attack the body. But the frequency appeared similar with the two techniques.

Older transplant patients are especially susceptible to infection from marrow transplants, said Dr. Joel Brochstein of the Hackensack University Medical Center in New Jersey. He said they may especially benefit from the faster recovery times with the newer technique.

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On the Net:

University of Minnesota Cancer Center:

http://www.cancer.umn.edu/page/research/trsplant/bmt.html

New England Journal of Medicine: http://www.nejm.com