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Stem cell patients ‘are healthy’

Blood cancer patients who had stem-cell transplants are virtually as healthy as their peers 10 years later, an American study has found.

Researchers at Fred Hutchinson Research Cancer Center looked at 137 patients a decade after their operations.

The study showed they were "largely indistinguishable" from the general population, said the report in the Journal of Clinical Oncology.

However, there was a higher incidence of some forms of disease.

More than 45,000 people receive stem-cell transplants across the world each year.

But the US researchers say there is very little information about long-term progress.

This study looked at patients who had received haematopoietic cell transplants (HCTs) to replace diseased blood-forming cells produced in the bone marrow.

Disease survey

All of the patients received their transplants between March 1987 and March 1990. Most of them had been treated for these two conditions.

After 10 years, researchers compared their health with that of 137 healthy people, most of whom were siblings of the patients.

They were questioned about 85 diseases and symptoms and asked to indicate whether they had these problems now, whether the diseases or symptoms were ever a problem in the past 10 years or were no longer a problem.

Twenty-seven diseases or conditions emerged as the most prevalent.

They ranged from asthma to secondary cancers.

Transplant survivors and the healthy control group were found to have had similar rates of hospitalisation and outpatient medical visits.

They also had similar rates of diseases and conditions such as asthma, diabetes, high blood pressure, high cholesterol, osteoporosis and hypothyroidism, and they had similar psychological health, marital satisfaction and employment.

But the transplant patients did have a higher incidence of musculoskeletal problems, such as stiffness and cramping; poor long-term sexual health and urinary tract problems.

They were also more likely to use antidepressant and anti-anxiety medicines, even though reported rates of depression and anxiety were about the same as that of the healthy group.

The researchers also identified under-diagnosed problems among transplant patients such as osteoporosis and under-active thyroid.

‘Good news’

But Dr Karen Syrjala, who led the study, said: "Ten years after HCT, the 137 survivors were indistinguishable from case-matched controls in many areas of health and psychosocial functioning, although survivors reported a greater number of medical problems and greater limitations in sexuality, insurance and social, emotional and physical roles.

"Some of these problems are known to be associated with HCT, while others have not been recognised previously as concerns."

The researchers also found the 10% of transplant survivors who had suffered relapse were in complete remission at the time of the study.

Dr Syrjala said: "The fact that patients can relapse and still have healthy, full lives 10 years later and look like everyone else who has gone through a transplant without relapse is really good news.

"In the past, relapse after a transplant was always thought to be a very bad sign for quality of life."

Dr Stephen Minger, director of King’s College London Stem Cell Biology Laboratory, said: "This is a proof of the principle that stem cell therapy works, when you are replacing blood cells with blood cells.

"Looking at replacing diseased heart cells with healthy heart cells, and diseased brain cells with healthy brain cells – that’s the next step."

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