Feasibility of allogeneic hematopoietic stem cell transplantation in advanced age.

Autor: Fernandez-Luis S; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain. Sara.fernandezl@scsalud.es., Gomez Lamas D; Hematology Department, Hospital Universitario Basurto, Bilbao, Spain., Cerezo Martin JM; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Mora Barrios JM; Hematology Department, Hospital Sierrallana, Torrelavega, Spain., Yañez San Segundo L; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain.; University of Cantabria, Santander, Spain., Sanchez Escamilla M; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Fernandez-Escalada N; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Calvo Sanchez JA; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Fernandez Garcia S; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Dominguez-Garcia JJ; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Colorado Araujo M; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Lopez-Duarte M; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Martin-Sanchez G; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Insunza Gaminde A; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Romon Alonso JI; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Lobeira Rubio R; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain., Arroyo Rodriguez JL; Banco de Sangre y Tejidos de Cantabria, Santander, Spain., Rueda Ciller B; Hematology Department, Hospital Miguel Servet, Zaragoza, Spain., Hermosilla Fernandez M; Hematology Department, Hospital San Pedro, Logroño, Spain., Marco Betes V; Hematology Department, Hospital San Jorge, Huesca, Spain., Ocio EM; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain.; University of Cantabria, Santander, Spain., Bermudez Rodriguez A; Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain.; University of Cantabria, Santander, Spain.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2024 Feb; Vol. 103 (2), pp. 583-591. Date of Electronic Publication: 2023 Nov 04.
DOI: 10.1007/s00277-023-05521-x
Abstrakt: 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.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: