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. 2024 Feb;103(2):583-591.
doi: 10.1007/s00277-023-05521-x. Epub 2023 Nov 4.

Feasibility of allogeneic hematopoietic stem cell transplantation in advanced age

Sara Fernandez-Luis  1 , David Gomez Lamas  2 , Juan Manuel Cerezo Martin  3 , Juan Manuel Mora Barrios  4 , Lucrecia Yañez San Segundo  3   5 , Miriam Sanchez Escamilla  3 , Noemi Fernandez-Escalada  3 , Jose Alvaro Calvo Sanchez  3 , Sergio Fernandez Garcia  3 , Juan Jose Dominguez-Garcia  3 , Mercedes Colorado Araujo  3 , Monica Lopez-Duarte  3 , Guillermo Martin-Sanchez  3 , Andres Insunza Gaminde  3 , Jose Iñigo Romon Alonso  3 , Rocio Lobeira Rubio  3 , Jose Luis Arroyo Rodriguez  6 , Beatriz Rueda Ciller  7 , Mar Hermosilla Fernandez  8 , Victor Marco Betes  9 , Enrique Maria Ocio #  3   5 , Arancha Bermudez Rodriguez #  3   5
Affiliations

Feasibility of allogeneic hematopoietic stem cell transplantation in advanced age

Sara Fernandez-Luis et al. Ann Hematol. 2024 Feb.

Abstract

Although it is known that increasing age is associated with increased morbidity and mortality in allogeneic transplantation (allo-HSCT), individualization of the process may allow to perform it in progressively older patients.This study analyzed the outcome of 97 patients older than 60 years with a first allo-HSCT performed at our institution between 2011 and 2019.Median age was 66 years (range 60-79) and 15.4% were older than 70 years. The most frequent diagnosis was acute leukemia (50.5%), and 58.8% received a myeloablative conditioning. With a median follow-up of 33.9 months (range 7.9-111.5), at 3-years overall survival (OS) was 50%; progression-free survival (PFS), 46%; cumulative incidence of relapse, 22%; and non-relapse mortality (NRM), 32%. There were no significant differences in OS (p = 0.415), PFS (p = 0.691), cumulative incidence of relapse (p = 0.357) or NRM (p = 0.658) between patients of 60-64 years (n = 37), 65-69 (n = 45) and ≥ 70 years (n = 15). No differences were observed either depending on the intensity of the conditioning regimen in terms of OS (p = 0.858), PFS (p = 0.729), cumulative incidence of relapse (p = 0.416) or NRM (p = 0.270).In conclusion, older adults can safely and effectively undergo allo-HSCT with proper patient selection and individualized transplantation procedures.

Keywords: Allogeneic hematopoietic stem cell transplantation; Elderly; Myeloablative conditioning; Non-relapse mortality; Survival.

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