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Transplant for Elderly Patients

Low transplant-related mortality with allogeneic stem cell transplantation in elderly patients

Bone Marrow Transplantation volume 34, pages 155–159 (2004)Cite this article

Summary:

Historically, age >60 years was considered a contraindication for allogeneic stem cell transplantation (allo-SCT). In recent years, elderly (>60 years) patients have become eligible for allo-SCT due to the application of reduced intensity conditioning (RIC). The present report summarizes our cumulative experience in a cohort of 17 elderly patients (age 60–67, median 62.5 years) with hematological malignancies treated with 18 allo-SCT procedures, mostly nonmyeloablative. In all, 14 patients received fludarabine and busulfan/busulfex regimen, three patients were conditioned with the fludarabine and low-dose TBI and one patient received busulfan alone. All patients displayed tri-lineage engraftment. The time to recovery of absolute neutrophil count ⩾0.5 × 109/l was 9–27 days (median 14 days). The time interval to platelet recovery ⩾20 × 109/l was 3–96 days (median 11 days). Veno-occlusive disease occurred only in 3/18 procedures and subsided with conventional treatment. Nonfatal transplant-related complications occurred in 6/18 (33.3%) procedures including: renal failure, arrhythmia, CNS bleeding, cystitis, typhlitis and gastrointestinal bleeding. Transplant-related mortality occurred in 6/18 (33.3%) episodes. Of the 17 patients, 12 (12/18 episodes) were discharged. Five of 17 (29%) patients survived (median follow-up 11 m, range 8–53 m). Our data suggest that RIC-allo-SCT may be safely applied in the elderly, suggesting that allogeneic immunotherapy may become an important tool for treatment of hematological malignancies without an age limit.

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Acknowledgements

We thank Professor Arnon Nagler for his devoted work while in working in our center. We also thank the Danny Cunniff Leukemia Research Laboratory, the Gabrielle Rich Leukemia Research Foundation, the Cancer Treatment Research Foundation, the Novotny Trust, The Szydlowsky Foundation, The Fig Tree Foundation, and Ronne & Donald Hess for their continuous support of our ongoing basic and clinical research.

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  1. Department of Bone Marrow Transplantation & Cancer Immunotherapy, Hadassah – Hebrew University Medical Center, Jerusalem, Israel

    M Y Shapira, I B Resnick, M Bitan, A Ackerstein, S Samuel, S Elad, S Miron, I Zilberman, S Slavin & R Or

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  1. M Y Shapira
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  8. I Zilberman
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  9. S Slavin
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Correspondence to M Y Shapira.

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Shapira, M., Resnick, I., Bitan, M. et al. Low transplant-related mortality with allogeneic stem cell transplantation in elderly patients. Bone Marrow Transplant 34, 155–159 (2004). https://doi.org/10.1038/sj.bmt.1704540

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