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Ratko TA, Belinson SE, Brown HM, et al. Hematopoietic Stem-Cell Transplantation in the Pediatric Population [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Feb. (Comparative Effectiveness Reviews, No. 48.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

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Hematopoietic Stem-Cell Transplantation in the Pediatric Population [Internet].

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Appendix FC-Peptide and HbA1c Outcomes

In all studies, serum C-peptide levels were measured using radioimmunoassay. To accommodate differences in data presentation and analysis, they are presented in the tables as a percentage change from values at study entry.

C-Peptide Level

Data on C-peptide levels were reported in all three studies included in this review, at follow-up times that range from 6 months in one IIT study (Crino et al, 2005, rec#23080) to more than 4 years in the HSCT study (Couri et al, 2009, rec#290) (Table F1). The proportional change in C-peptide levels in the HSCT study refer only to patients who remained continuously insulin free.

AppendixTable F1. C-peptide levels following autologous HSCT or IIT in pediatric patients.

AppendixTable F1

C-peptide levels following autologous HSCT or IIT in pediatric patients.

The data in Table F1 show that C-peptide levels following a mixed-meal tolerance test were significantly increased above baseline values in the HSCT study (Couri et al, 2009, rec#290) for more than two years in 8 of 12 patients who became continuously insulin free following the procedure. In one IIT study, mean fasting C-peptide levels were not changed significantly at 1 or 2 years following initiation of treatment from that at study entry (Crino et al, 2005, rec#23080). In the second IIT study, the mean C-peptide level following a Boost meal test was slightly lower at 6 months following initiation of treatment than that at study entry (Mastrandrea et al, 2009, rec#40050).

Hemoglobin A1C Levels

Table F2 shows HbA1C levels in patients treated with nonmyeloablative autologous HSCT (Couri et al, 2009, rec#290) or IIT (Crino et al, 2005, rec#23080; Mastrandrea et al, 2009, rec#40050).

AppendixTable F2. HbA1C levels following autologous HSCT or IIT in pediatric patients.

AppendixTable F2

HbA1C levels following autologous HSCT or IIT in pediatric patients.

Hemoglobin A1C (HbA1C) levels pretransplant ranged from 5.4% to 11.6% (mean 8.4 ± 1.6%) among 18 pediatric patients in the HSCT study (Couri et al, 2009, rec#290). Among those who became continuously insulin-free, HbA1C declined from a mean 8.0% to 5.7%, 5.7%, 5.5%, and 6.0%, respectively, at 12, 24, 36, and 48 months after transplantation (p < 0.001 at all time points versus pretreatment value).

In one IIT study, HbA1C did not change significantly from a mean 10.5 ± 2.2% at diagnosis to 5.4 ± 0.8% and 6.5 ± 0.9% at 12 and 24 months, respectively (Crino et al, 2005, rec# 23080). In the second IIT study, mean HbA1C at study entry (12.4 ± 2.5%) declined to an average 7.0 ± 1.2% (p-value NR) (Mastrandrea et al, 2009, rec#40050).

Bookshelf ID: NBK84616

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