Donor Age Influences Graft-Versus-Host Disease Relapse-Free Survival after Allogeneic Stem Cell Transplant in Elderly Patients in Two Countries from Latin America.

Autor:	Berro M; HSCT Unit, Hospital Universitario Austral, Pilar, Argentina., Hamerschlak N; HSCT Unit, Hospital Israelita Albert Einstein, San Pablo, Brazil., Milovic V; HSCT Unit, Hospital Aleman, Buenos Aires, Argentina., Castro B; HSCT Unit, Hospital Privado de Cordoba, Cordoba, Argentina., García AP; HSCT Unit, Hospital Privado de Cordoba, Cordoba, Argentina., Ferini G; HSCT Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Real JJ; HSCT Unit, Hospital Aleman, Buenos Aires, Argentina., Vitriu A; HSCT Unit, Instituto Alexander Fleming, Buenos Aires, Argentina., Conca AG; HSCT Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Bendek G; HSCT Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Yantorno S; HSCT Unit, Hospital Italiano La Plata, La Plata, Argentina., Rolon JM; HSCT Unit, FUNDALEU, Buenos Aires, Argentina., Saslavsky M; HSCT Unit, CETRAMOR, Rosario, Argentina., Jarchum S; HSCT Unit, Sanatorio Allende, Cordoba, Argentina., Cerutti A; HSCT Unit, Sanatorio Britanico, Rosario, Argentina., da Silva CC; HSCT Unit, Hospital Israelita Albert Einstein, San Pablo, Brazil., Rodrigues M; HSCT Unit, Hospital Israelita Albert Einstein, San Pablo, Brazil., Riera L; HSCT Unit, CEMIC, Buenos Aires, Argentina., Arbelbide J; HSCT Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Kusminsky G; HSCT Unit, Hospital Universitario Austral, Pilar, Argentina., Basquiera AL; HSCT Unit, Hospital Privado de Cordoba, Cordoba, Argentina.
Jazyk:	angličtina
Zdroj:	Hematology/oncology and stem cell therapy [Hematol Oncol Stem Cell Ther] 2023 May 23; Vol. 16 (4), pp. 330-336. Date of Electronic Publication: 2023 May 23.
DOI:	10.56875/2589-0646.1042
Abstrakt:	Background and Objectives: Allogeneic stem cell transplantation (Allo-SCT) in elderly patients is a growing practice. We aimed to determine the graft-versus-host disease (GVHD) relapse-free survival (GRFS) in patients ≥65 years who underwent Allo-SCT in two countries from Latin America. Patients and Methods: We performed a retrospective analysis of patients ≥65 years who underwent Allo-SCT in Argentina and Brazil from 2007 to 2019. Results: Ninety-eight patients were evaluated, with primary diagnoses of acute myeloid leukemia and myelodysplastic syndrome; 30% of patients had a hematopoietic cell transplant-comorbidity index (HCT-CI) score ≥3 and 49% were in complete remission. Donor types included matched sibling (n = 41), matched unrelated (n = 31), and haploidentical (HID; n = 26) donors. The conditioning regimen was myeloablative in 28 patients (14 busulfan pharmacokinetically [PK]-guided) and reduced-intensity in 70 patients. The two-year non-relapse mortality (NRM) was 29%, with a higher NRM in melphalan-based compared to other conditionings (51% vs. 33%, p = 0.02). The two-year relapse rate was 24%, with a reduction in PK-guided busulfan (0% vs. 28%, p = 0.03). The two-year overall survival (OS) and GRFS was 52% and 38%, respectively, with a significant reduction in GRFS in HCT-CI ≥3 (27% vs. others 42%, p = 0.02) and donors ≥40 years (29% vs. <40 years 55%, p = 0.02). These variables remained significantly associated with GRFS after multivariate analysis. Conclusion: In this cohort of elderly patients from Argentina and Brazil undergoing Allo-SCT, donor age and comorbidities significantly influenced GRFS. The role of the conditioning regimen in this population deserves further investigation.
Databáze:	MEDLINE
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