Hematopoietic stem cell transplantation (SCT) is an intensive, costly and effective treatment for many malignant and non-malignant diseases. Long-term survivors are at risk for diverse late effects. Complications occurring beyond the first year post-SCT include relapsed disease, toxic effects of myeloablative preparative regimens, compromised immunity with consequent infections, graft-versus-host disease and new cancers. These and other problems contribute to excess mortality compared to the normal population, impaired functional status and inability to work. As increasing numbers of patients receive SCT and survive, understanding the frequency and severity of late effects takes on greater importance. New SCT technologies, designed primarily to reduce early transplant-related complications, may have little effect on or even worsen late problems. Using the resources of the International Bone Marrow Transplant Registry and the Autologous Blood and Marrow Transplant Registry, the candidate's research program will include a multi-faceted evaluation of SCT, including consideration of SCT costs, with on emphasis on late consequences. The specific research aims of this proposal are to: 1) to determine the incidence of and risk factors for late adverse events among persons surviving two or more years after allogeneic or autologous hematopoietic stem cell transplantation; and, 2) to compare HLA-identical sibling bone marrow versus peripheral blood stem cell transplants for leukemia for incidence and severity of chronic graft-versus-host disease, risk of relapse, direct medical costs and functional status. Completion of these projects will contribute in a meaningful way to our understanding of the long term consequences of stem cell transplantation. They also, in concert with formal course work, close mentoring, and collaboration with experts in SCT, statistics, epidemiology, and economics will develop the candidate's competence in many aspects of outcomes research, including study design, management and analysis of large databases, statistical methods for survival and cost analyses, and multi-center collaboration.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23CA082350-03
Application #
6377338
Study Section
Subcommittee G - Education (NCI)
Project Start
1999-09-03
Project End
2004-06-30
Budget Start
2001-07-11
Budget End
2002-06-30
Support Year
3
Fiscal Year
2001
Total Cost
$132,755
Indirect Cost
Name
Medical College of Wisconsin
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073134603
City
Milwaukee
State
WI
Country
United States
Zip Code
53226
Bishop, Michelle M; Lee, Stephanie J; Beaumont, Jennifer L et al. (2010) The preventive health behaviors of long-term survivors of cancer and hematopoietic stem cell transplantation compared with matched controls. Biol Blood Marrow Transplant 16:207-14
Landgren, Ola; Gilbert, Ethel S; Rizzo, J Douglas et al. (2009) Risk factors for lymphoproliferative disorders after allogeneic hematopoietic cell transplantation. Blood 113:4992-5001
Bishop, Michelle M; Beaumont, Jennifer L; Hahn, Elizabeth A et al. (2007) Late effects of cancer and hematopoietic stem-cell transplantation on spouses or partners compared with survivors and survivor-matched controls. J Clin Oncol 25:1403-11
Rizzo, J Douglas; Wingard, John R; Tichelli, Andre et al. (2006) Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation: joint recommendations of the European Group for Blood and Marrow Transplantation, the Center for International Blood and Marrow Transplant Res Biol Blood Marrow Transplant 12:138-51
Schmitz, Norbert; Eapen, Mary; Horowitz, Mary M et al. (2006) Long-term outcome of patients given transplants of mobilized blood or bone marrow: A report from the International Bone Marrow Transplant Registry and the European Group for Blood and Marrow Transplantation. Blood 108:4288-90
Rizzo, J D; Wingard, J R; Tichelli, A et al. (2006) Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation: joint recommendations of the European Group for Blood and Marrow Transplantation, Center for International Blood and Marrow Transplant Researc Bone Marrow Transplant 37:249-61
Curtis, Rochelle E; Metayer, Catherine; Rizzo, J Douglas et al. (2005) Impact of chronic GVHD therapy on the development of squamous-cell cancers after hematopoietic stem-cell transplantation: an international case-control study. Blood 105:3802-11
Andrykowski, Michael A; Bishop, Michelle M; Hahn, Elizabeth A et al. (2005) Long-term health-related quality of life, growth, and spiritual well-being after hematopoietic stem-cell transplantation. J Clin Oncol 23:599-608