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. 2017 Nov;52(11):1530-1536.
doi: 10.1038/bmt.2017.182. Epub 2017 Sep 4.

Age does not adversely influence outcomes among patients older than 60 years who undergo allogeneic hematopoietic stem cell transplant for AML and myelodysplastic syndrome

D Modi  1 , A Deol  2 , S Kim  3 , L Ayash  2 , A Alavi  2 , M Ventimiglia  4 , D Bhutani  2 , V Ratanatharathorn  2 , J P Uberti  2
Affiliations

Age does not adversely influence outcomes among patients older than 60 years who undergo allogeneic hematopoietic stem cell transplant for AML and myelodysplastic syndrome

D Modi et al. Bone Marrow Transplant. 2017 Nov.

Abstract

Allogeneic hematopoietic stem cell transplant (AHSCT) outcomes data of older AML/myelodysplastic syndrome (MDS) patients are limited. We retrospectively evaluated consecutive patients ⩾60 years old with AML/MDS who underwent AHSCT between January 2005 and December 2014. The primary objectives were to determine nonrelapse mortality (NRM), relapse, relapse-free survival (RFS) and overall survival (OS) at 1 year post AHSCT. A total of 159 patients underwent AHSCT with a median age of 64 (range, 60-75) years. Of these, 103 patients (65%) had AML and 56 patients (35%) had MDS. At 1 year post AHSCT, grade III-IV acute GvHD and chronic GvHD occurred in 20.8% (95% confidence interval (CI), 14.9-27.5%) and 54.1% (95% CI, 46.0-61.5%) of patients, respectively. NRM, RFS, relapse rate and OS at 1 year post AHSCT were 25.3% (95% CI, 18.8-32.3%), 53.3% (95% CI, 46.1-61.7%), 21.4% (95% CI, 15.4-28.1%) and 56.4% (95% CI, 49.2-54.7%), respectively. High disease risk index was associated with poor RFS, OS and higher relapse rate (P<0.03), whereas non-thymoglobulin-based GvHD prophylaxis, higher comorbidity index (⩾3) and MDS were associated with higher NRM (P<0.03). Importantly, age did not have an adverse effect on NRM, relapse, RFS and OS. AHSCT was well tolerated. Hence, older age alone should not be considered a contraindication to AHSCT.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
(a) Cumulative incidence of grade III–IV aGvHD after transplantation with disease relapse or death without grade III–IV aGvHD as competing risks. (b) Cumulative incidence of cGvHD after transplantation with disease relapse or death without cGvHD as competing risks.
Figure 2.
Figure 2.
(a) Cumulative incidence of relapse after transplantation with death without relapse as a competing risk. (b) Cumulative incidence of NRM after transplantation with disease relapse as a competing risk.
Figure 3.
Figure 3.
OS, RFS and GRFS estimates.
See this image and copyright information in PMC

References

    1. Yamamoto JF, Goodman MT. Patterns of leukemia incidence in the United States by subtype and demographic characteristics, 1997–2002. Cancer Causes Control 2008; 19: 379–390. - PubMed
    1. Appelbaum FR, Gundacker H, Head DR, Slovak ML, Willman CL, Godwin JE et al. Age and acute myeloid leukemia. Blood 2006; 107: 3481–3485. - PMC - PubMed
    1. Mamdani H, Santos CD, Konig H. Treatment of acute myeloid leukemia in elderly patients-a therapeutic dilemma. J Am Med Dir Assoc 2016; 17: 581–587. - PubMed
    1. Ossenkoppele G, Lowenberg B. How I treat the older patient with acute myeloid leukemia. Blood 2015; 125: 767–774 - PubMed
    1. Baudard M, Marie JP, Cadiou M, Viguie F, Zittoun R. Acute myelogenous leukaemia in the elderly: retrospective study of 235 consecutive patients. Br J Haematol 1994; 86: 82–91. - PubMed

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