DESCRIPTION: (Applicant's Description)
This application proposes to evaluate factors requiring intervention to
enhance long-term survival in adults after blood or marrow transplantation
(BMT). In previous work, we have followed patients prospectively from
pre-transplant with psychophysical, neuropsychologic, and endocrinologic
assessments. With this application, we would continue outcome evaluation of
two cohorts of survivors. We have followed the first cohort to five years
and will complete a ten-year follow-up to evaluate late effects (n = 108
five year survivors plus a matched comparison sample). The second cohort of
survivors participated in a randomized controlled clinical trial to enhance
recovery from BMT. This cohort will complete follow-up to five years, with
testing that includes neuropsychologic and endocrinologic evaluation (n =
100 five year survivors plus a matched comparison sample) to determine
long-term survivor issues and efficacy of the clinical trial. A small
subset of the second cohort would participate in a pilot study of
interventions to reduce long-term impacts in at-risk survivors. Specific
aims are to: 1) evaluate the functional capabilities of adult BMT
recipients in work, stamina, cognition, family adaptations, emotional
fluctuations, infertility, and, for women, menopausal symptoms and sexual
function; 2) evaluate the interaction of medical and psychophysical late
effects in ten-year survivors as compared with their own status at five
years and pre-transplant; 3) identify areas that have an impact on long-term
survivors to a greater extent than matched healthy comparison samples; 4)
define predictors of physiologic and psychologic morbidity in long-term
survivors; 5) examine, prospectively, long-term neuropsychological and
hormonal changes and their impacts; 6) evaluate the long-term outcome of a
randomized controlled clinical trial to enhance recovery; and 7) design and
pilot interventions to target at-risk long-term survivors as defined by this
research. Hypotheses are defined in the application. This study is an
interdisciplinary research effort which considers medical, psychological,
social, functional, hormonal, and neuropsychological interactions in
addressing the problems and needs of long-term survivors. The BMT setting
provides a well standardized environment in which to examine these aims, all
of which are applicable both to the ever-increasing numbers of
transplantation survivors and to other populations of cancer survivors.
Error Notice
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We apologize for the inconvenience.
- The DCCPS Team.
