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To the Editor: The study by Dr Couri and colleagues¹ provided follow-up of a preliminary report.² The current article included 23 patients, with a mean follow-up that was increased from 18.8 to 29.8 months.

After removing from the analysis 3 patients who were not able to have insulin suspended, the authors stated that 12 of 20 patients (60%) remained insulin-free for a mean of 31 months after transplantation. We consider this a biased analysis; including the 3 nonresponders would have indicated a success rate of 12 of 23 (52.1%).

In addition, we are concerned about reporting a crude success rate after a mean follow-up of 29.8 months. In a longitudinal trial, actuarial (life-table) analysis of the data would have been more appropriate. The data should be available in Table 1 to conduct such an analysis.

Financial Disclosures: None reported.

Pablo R. Olmos, MD
polmos@med.puc.cl
Department of Nutrition, Diabetes, and Metabolism

Gisella Borzone, MD, PhD
Department of Respiratory Diseases
College of Medicine
Pontificia Universidad Católica de Chile
Santiago, Chile

1. Couri CE, Oliveira MC, Stracieri AB; et al. C-peptide levels and insulin independence following autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus. JAMA. 2009;301(15):1573-1579. FREE FULL TEXT 2. Voltarelli JC, Couri CE, Stracieri AB; et al. Autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus. JAMA. 2007;297(14):1568-1576. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2009;302(6):624.

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C-Peptide Levels and Insulin Independence Following Autologous Nonmyeloablative Hematopoietic Stem Cell Transplantation in Newly Diagnosed Type 1 Diabetes Mellitus
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