Effective treatment of blood thinners: A Synthesis of Findings from 28 Studies
- Home
- Effective treatment of blood thinners
This analysis is based on research papers included in PubMed, but medical research is constantly evolving and may not fully reflect the latest findings. There may also be biases towards certain research areas.
This information is not medical advice and is not a substitute for diagnosis or treatment by a physician. If you have concerns about "Effective treatment of blood thinners: A Synthesis of Findings from 28 Studies", please consult your doctor.
For NLM copyright information, please see Link to NLM Copyright Page
PubMed data is obtained via Hugging Face Datasets: Link to DatasetPlease check the disclaimer.
Major Research Findings
Several studies have investigated the effectiveness of different treatments for blood cancers, including leukemia and lymphoma. 14 compared autologous bone marrow transplantation with intensive consolidation chemotherapy for children with acute myeloid leukemia (AML) in first remission. The study found that the value of autologous bone marrow transplantation for treating children with AML is unknown. 26 investigated the impact of disease risk on the efficacy of HLA-matched related bone marrow transplantation (BMT) for pediatric patients with newly diagnosed AML. This study suggested that BMT might be a suitable option for patients with high-risk AML.
6 studied the effectiveness of high-dose bolus methylprednisolone (BMPr) for treating acute graft versus host disease (GvHD) following bone marrow transplantation (BMT). The study found that BMPr was effective in treating established acute GvHD, with a complete response rate of 43% in HLA-matched transplant recipients. However, the effectiveness of BMPr in HLA-mismatched transplant recipients was unclear.
19 conducted a prospective randomized trial to compare the effectiveness of Filgrastim (r-metHuG-CSF) given at different times after unrelated bone marrow transplantation (BMT). The study found that starting Filgrastim treatment on day 10 after BMT, rather than on day 0, reduced the costs of Filgrastim without significantly affecting hematological recovery, incidence of GvHD, or survival rates.
4 compared three consolidation regimens in patients with acute myelogenous leukemia in first remission: intensive consolidation chemotherapy (SIC), autologous bone marrow transplant (auto-BMT), and allogeneic BMT (allo-BMT). The study found that the auto-BMT group had a lower relapse rate than the SIC group, but the difference was not statistically significant.
13 compared two preparatory regimens for allogeneic bone marrow transplantation (BMT) from histocompatible sibling donors: fractionated total body irradiation and etoposide (FTBI/VP-16) and high-dose busulfan with cyclophosphamide (BU/CY). The study found no significant difference in overall survival or disease-free survival between the two regimens. However, for “poor-risk” patients, FTBI/VP-16 might offer better survival outcomes than BU/CY.
10 randomized leukemic patients receiving marrow from HLA-identical sibling donors to receive additional treatment with either busulfan or total body irradiation (TBI). The study found that busulfan-treated patients had a higher cumulative incidence of veno-occlusive disease of the liver and hemorrhagic cystitis, and a higher transplant-related mortality in patients with advanced disease. TBI emerged as the preferred treatment, particularly for adults and those with advanced disease. Busulfan was considered a suitable alternative for patients with early disease or when TBI wasn’t feasible.
18 examined bone loss and turnover following allogeneic BMT. The study revealed a significant bone loss during the first six months post-transplant, with no further decline observed between 6 and 12 months. Supplementation with calcium and calcitonin did not prevent bone loss.
12 conducted a long-term follow-up of patients with lymphoid malignancies who received rhGM-CSF or placebo after autologous bone marrow transplantation (ABMT). The study found no apparent long-term deleterious effects on bone marrow function associated with rhGM-CSF, indicating its safety.
24 conducted a systematic review of studies comparing autologous stem cells derived from peripheral blood to standard bone marrow transplant. The review found that peripheral blood stem cell transplantation resulted in faster neutrophil recovery compared to bone marrow transplantation, suggesting a potential benefit in terms of faster recovery from chemotherapy.
1 randomized patients undergoing allogeneic bone marrow transplantation (BMT) to receive fresh or stored platelet concentrates (PC). The study found no significant difference in the need for platelets or posttransfusion corrected count increment between the two groups, indicating that using stored PC might be a viable option for managing platelet levels.
21 discussed the importance of nutrition support for bone marrow transplant patients, highlighting the potential for malnutrition due to poor appetite, mucositis, and gastrointestinal failure. Parenteral nutrition (PN) is often the first choice for nutritional support but carries an increased risk of infection. Enteral nutrition (EN) is an alternative, and the addition of substrates like glutamine to enteral and parenteral solutions might also be beneficial. The relative effectiveness of these treatments requires further investigation.
9 compared allogeneic or autologous bone marrow transplantation with intensive consolidation chemotherapy for treating acute myelogenous leukemia in first complete remission. The study highlighted the need for further research to determine the optimal treatment approach for this condition.
11 evaluated the clinical and cost effectiveness of GM-CSF in patients undergoing autologous bone marrow transplantation (AuBMT) for Hodgkin's disease. The study found that administering GM-CSF after AuBMT enhanced myeloid and platelet recovery, making it a cost-effective option for treating patients with relapsed Hodgkin's disease.
compared chemotherapy alone with allogeneic bone marrow transplantation in children with acute myeloid leukemia in first complete remission. The study found no significant difference in outcomes between the two groups, but the BMT group experienced higher early and late toxicity. The study concluded that allogeneic BMT might not be advantageous in first complete remission, and it should be reserved for high-risk patients.
8 conducted a prospective randomized study to determine the optimal timing of granulocyte colony-stimulating factor (G-CSF) administration after bone marrow transplantation. The study found no significant differences in the time to reach neutrophil and platelet recovery between starting G-CSF on day 0 or day +7 post-BMT, but starting on day +7 resulted in cost savings.
27 updated a Cochrane review on nutrition support for bone marrow transplant patients. The review confirmed that PN carries an increased risk of infection, while EN might be a more suitable option.
17 studied the long-term effects of busulfan versus total body irradiation as conditioning regimens for allogeneic marrow recipients with leukemia. The study found that busulfan-treated patients had an increased risk of chronic graft-versus-host disease (GvHD), obstructive bronchiolitis, and alopecia. In patients with more advanced disease, TBI was associated with better leukemia-free survival compared to busulfan.
22 compared transplantation of mobilized peripheral blood progenitor cells to HLA-identical siblings with standard-risk leukemia. The study found that peripheral blood progenitor cells and bone marrow transplantation yielded comparable survival rates, but peripheral blood progenitor cells were associated with a higher incidence of acute and chronic GvHD.
2 evaluated the effects of intravenous infusions of granulocyte-macrophage colony-stimulating factor (GM-CSF) in patients undergoing autologous bone marrow transplantation after total body irradiation. The study found that GM-CSF treatment resulted in a tendency towards faster neutrophil regeneration and a decreased need for erythrocyte transfusions, suggesting its potential benefit in this setting.
5 conducted a randomized controlled trial to assess the effectiveness of ex-vivo depletion of T lymphocytes from donor bone marrow using a monoclonal anti-T-cell antibody and complement for preventing GvHD. The study found that patients receiving T-cell-depleted bone marrow had a lower incidence of acute GvHD, reduced mortality due to GvHD, and similar infection rates and overall survival compared to controls.
15 compared allogeneic bone marrow transplantation (alloBMT), autologous stem cell transplantation (ASCT), and chemotherapy in adult patients with acute myeloid leukemia (AML). The study found that alloBMT was associated with better disease-free survival and lower relapse rates compared to ASCT or chemotherapy.
16 reviewed the literature on radiotherapy related to bone marrow transplantation. The review highlighted the heterogeneity of whole-body irradiation methods and advocated for standardization. For advanced-stage leukemia and other diseases, combined treatment with high-dose cyclophosphamide and whole-body irradiation appeared to be superior to chemotherapy alone.
20 monitored treatment results and survival in chronic myeloid leukemia after allogeneic bone marrow transplantation (alloBMT) and the introduction of interferon alpha (IFNalpha). The study observed improved treatment outcomes and survival with alloBMT and IFNalpha.
28 , a Cochrane review on nutrition support for bone marrow transplant patients, was withdrawn.
25 updated a Cochrane review on nutrition support for bone marrow transplant patients. The review confirmed that PN carries a higher risk of infection, making EN a preferable option for nutritional support.
23 conducted a meta-analysis comparing consolidation therapy with autologous bone marrow transplantation and non-myeloablative chemotherapy in adults with acute myeloid leukemia. The meta-analysis found that autologous bone marrow transplantation was associated with better outcomes compared to non-myeloablative chemotherapy alone.
Treatment Summary
The research highlights various treatments for blood cancers, including autologous and allogeneic bone marrow transplantation, chemotherapy, and targeted therapies like Filgrastim and GM-CSF. 14 and 26 focus on AML treatment options for children, emphasizing the importance of considering disease risk when choosing between autologous bone marrow transplantation and chemotherapy. further emphasizes the need to reserve allogeneic bone marrow transplantation for high-risk patients. 21 stresses the importance of proper nutrition support for bone marrow transplant patients to prevent malnutrition and potential complications.
Benefits and Risks
Benefits Summary
Bone marrow transplantation offers potential benefits for patients with blood cancers, including improved disease-free survival, lower relapse rates, and enhanced overall survival. 15 demonstrated the superiority of allogeneic bone marrow transplantation over autologous transplantation and chemotherapy in adult AML patients. 23 further supported the efficacy of autologous bone marrow transplantation for adults with AML in first remission.
Risks Summary
Bone marrow transplantation comes with various risks, including GvHD, infections, and bone loss. 6 highlighted the potential complications of BMPr, including hyperglycemia and gastritis, and emphasized the need for further research on its effectiveness in HLA-mismatched transplant recipients. 10 found that busulfan was associated with a higher incidence of liver complications and transplant-related mortality in patients with advanced disease. 18 demonstrated the occurrence of significant bone loss following BMT. 22 observed a higher incidence of acute and chronic GvHD in patients receiving peripheral blood progenitor cells compared to bone marrow transplantation.
Comparison of Studies
Commonalities
Most studies emphasize the importance of personalized medicine, tailoring treatments to individual patient needs based on factors like age, disease risk, and overall health. 21 highlights the need for nutrition support to prevent malnutrition in bone marrow transplant patients, while 16 underscores the need for standardization in whole-body irradiation techniques. 20 demonstrated that the combination of allogeneic bone marrow transplantation and IFNalpha improves outcomes in chronic myeloid leukemia.
Differences
The research encompasses diverse aspects of blood cancer treatments, including different treatment modalities, patient populations, and study designs. For example, 14 focused on the effectiveness of autologous bone marrow transplantation versus chemotherapy in children with AML, while 26 explored the impact of disease risk on the efficacy of HLA-matched related bone marrow transplantation.
Consistency and Contradictions
The research findings display both consistency and contradictions. 15 found that allogeneic bone marrow transplantation led to better disease-free survival than autologous transplantation or chemotherapy in adult AML patients, but observed no significant difference in outcomes between allogeneic bone marrow transplantation and chemotherapy in children with AML. Similarly, 22 observed a higher incidence of GvHD with peripheral blood progenitor cells, while 5 found that T-cell depleted bone marrow transplantation reduced the incidence of acute GvHD. These contradictions might be attributed to differences in study design, patient populations, or specific treatment approaches.
Real-World Applications and Considerations
While these studies provide valuable insights into treatment options for blood cancers, they underscore the importance of individualized care. The optimal treatment approach for each patient depends on their unique circumstances, including the type and stage of cancer, overall health, and potential risks and benefits of each treatment. Patients should consult with their healthcare providers to discuss their specific situation and determine the best treatment plan.
Limitations of Current Research
The studies discussed have limitations, such as limited sample sizes, variations in study designs, and potential for bias. 23 , a meta-analysis, while beneficial for summarizing existing research, is susceptible to bias from the included individual studies. Furthermore, some studies lacked long-term follow-up, hindering the assessment of long-term effects and potential late complications.
Future Research Directions
Continued research is necessary to further refine our understanding of blood cancer treatment effectiveness and safety. Areas of focus include developing innovative therapies, exploring novel prevention strategies, conducting long-term follow-up studies, and promoting personalized medicine approaches. 21 highlighted the need for further investigation into optimal nutrition support for bone marrow transplant patients, while 16 stressed the importance of standardizing whole-body irradiation techniques.
Conclusion
Bone marrow transplantation and chemotherapy remain crucial tools for treating blood cancers, but navigating the complexities of these treatments necessitates careful consideration of individual patient factors and potential benefits and risks. 15 and 23 suggest the efficacy of various bone marrow transplantation approaches, while 6 , 10 , 18 , and 22 highlight associated risks. Working closely with healthcare providers is essential for informed decision-making, selecting appropriate treatments, and managing potential complications. Continued research and innovation are crucial for improving treatment outcomes and minimizing risks for patients with blood cancers.
Treatment List
Autologous bone marrow transplantation, Allogeneic bone marrow transplantation, Intensive consolidation chemotherapy, High-dose methylprednisolone, Filgrastim, Non-myeloablative chemotherapy, Total body irradiation, Etoposide, Busulfan, Cyclophosphamide, Calcium, Calcitonin, rhGM-CSF, Peripheral blood stem cell transplantation, Fresh platelet concentrates, Stored platelet concentrates, Parenteral nutrition, Enteral nutrition, Interferon alpha, T-cell depletion
Benefit Keywords
Risk Keywords
Article Type
Author: ShanwellA, LarssonS, AschanJ, RingdénO
Language : English
Author: JessenP, NielsenB, JensenI M, EllegaardJ, HoklandP
Language : Danish
Author: CreutzigU, Bender-GötzeC, KlingebielT, EbellW, FriedrichW, Stollmann-GibbelsB, SchmidtH, SuttorpM, GratwohlA, HeyenP
Language : German
Author: WillemzeR, FibbeW E, Kluin-NelemansJ C, FalkenburgJ H, RichelD J, PetersW G, den OttolanderG J, BrandA, ZwaanF E
Language : English
Author: MitsuyasuR T, ChamplinR E, GaleR P, HoW G, LenarskyC, WinstonD, SelchM, ElashoffR, GiorgiJ V, WellsJ
Language : English
Author: BacigalupoA, van LintM T, FrassoniF, Podesta'M, VenezianoG, AvanziG, VitaleV, MarmontA M
Language : English
Author: PhilipT, GuglielmiC, HagenbeekA, SomersR, Van der LelieH, BronD, SonneveldP, GisselbrechtC, CahnJ Y, HarousseauJ L
Language : English
Author: Torres GómezA, JimenezM A, AlvarezM A, RodriguezA, MartinC, GarciaM J, FloresR, SanchezJ, de la TorreM J, HerreraC
Language : English
Author: ZittounR A, MandelliF, WillemzeR, de WitteT, LabarB, ResegottiL, LeoniF, DamasioE, VisaniG, PapaG
Language : English
Author: RingdénO, RuutuT, RembergerM, NikoskelainenJ, VolinL, VindeløvL, ParkkaliT, LenhoffS, SallerforsB, LjungmanP
Language : English
Author: GulatiS, BennettC, PhillipsJ, Van-PoznakC
Language : English
Author: RabinoweS N, NeubergD, BiermanP J, VoseJ M, NemunaitisJ, SingerJ W, FreedmanA S, MauchP, DemetriG, OnettoN
Language : English
Author: BlumeK G, KopeckyK J, Henslee-DowneyJ P, FormanS J, StiffP J, LeMaistreC F, AppelbaumF R
Language : English
Author: RavindranathY, YeagerA M, ChangM N, SteuberC P, KrischerJ, Graham-PoleJ, CarrollA, InoueS, CamittaB, WeinsteinH J
Language : English
Author: ReiffersJ, StoppaA M, AttalM, MichalletM, MaritG, BlaiseD, HuguetF, CorrontB, Cony-MakhoulP, GastautJ A, LaurentG, MolinaL, BroustetA, MaraninchiD, PrisJ, HollardD, FaberesC
Language : English
Author: AlvegårdT
Language : English
Author: RingdénO, RembergerM, RuutuT, NikoskelainenJ, VolinL, VindeløvL, ParkkaliT, LenhoffS, SallerforsB, MellanderL, LjungmanP, JacobsenN
Language : English
Author: VälimäkiM J, KinnunenK, VolinL, TähteläR, LöyttyniemiE, LaitinenK, MäkeläP, KetoP, RuutuT
Language : English
Author: HägglundH, RingdénO, OmanS, RembergerM, CarlensS, MattssonJ
Language : English
Author:
Language : English
Author: MurrayS M, PindoriaS
Language : English
Author: SchmitzNorbert, BeksacMeral, HasencleverDirk, BacigalupoAndrea, RuutuTapani, NaglerArnon, GluckmanEliane, RussellNigel, ApperleyJane F, GorinNorbert C, SzerJeff, BradstockKen, BuzynAgnes, ClarkPeter, BorkettKeith, GratwohlAlois,
Language : English
Author: NathanPaul C, SungLillian, CrumpMichael, BeyeneJoseph
Language : English
Author: LewisAlly
Language : English
Author: MurraySusan M, PindoriaSima
Language : English
Author: HoranJohn T, AlonzoTodd A, LymanGary H, GerbingRobert B, LangeBeverly J, RavindranathYaddanapudi, BectonDavid, SmithFranklin O, WoodsWilliam G,
Language : English
Author: MurraySusan M, PindoriaSima
Language : English
Author: MurraySusan M, PindoriaSima
Language : English
This site uses cookies. Visit our privacy policy page or click the link in any footer for more information and to change your preferences.