Week 6!

So now that the data collection is all done, I figured I would go more in-depth on our actual body of patients: so essentially the demographics of our patient population. As I mentioned in early posts the patients were sorted into different BMI classes based on the WHO standards and % BMI lost classes which I decided on myself. However, even if the results come back and there is some statistically significant association, there is another issue. For example, say we find that we find underweight patients typically have worse outcomes overall. At first we might say, physicians should monitor pre-transplant and not go through with the transplant until the patient has reached a certain weight threshold. However, what if it's simply that underweight patients had simply not taken the chemo as well or their bodies are in a worse condition to begin with? In that case, increasing weight doesn't seem to help the situation. To lower the extent of this issue, I looked further into the demographics of our patient population.
Patient Diseases
Acute Myeloid Leukemia (AML)
Chronic Myeloid Leukemia (CML)
Chronic Lymphocytic Leukemia (CLL)
Acute Lymphoblastic Leukemia (ALL)
Myelodysplastic Syndrome (MDS)
Non Hodgkin's Lymphoma (NHL)
Hodgkin's Disease (HD)
Other

Credit: CIBMTR Summary Slides

As we can see, a large portion of patients die from their primary disease when it relapses.

However, some diseases are far more commonly treated with allogeneic stem cell transplantation than others and as we can expect, survival rates can be vastly different (e.g. with MDS and AML).

Pre-Transplant Conditioning Regimen

There are two types we can see in the diagram below: Reduced-Intensity Conditioning (RIC) or Myeloablative Conditioning.  Myeloablative conditioning is basically using the high doses of chemo and radiation with the goal of getting rid of everything in the bone marrow in preparation for the transplant. RIC is pretty self-explanatory,.

Disease Risk 

The stage of a person's disease also comes into play, with more advanced stages showing inferior outcomes. The  diseases were categorized as low medium or high risk based on CIBMTR standards. 

Here are some examples to help you guys out. Now examining the demographics of the population doesn't really "help" in any way. It's mostly used so that associations between weight loss and say overall survival don't have any underlying causes. For example, if we found a vast majority patients who lost >10% BMI within a 100 days had a low overall survival rate, but most of those patients came in with high risk AML, the association might mean less. 

Hope that helped and see you guys next week!