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Acute Leukemia

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

Bone Marrow Transplantation volume 52, pages 1530–1536 (2017)Cite this article

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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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Acknowledgements

The study data were presented at the American Society of Hematology (ASH) annual meeting 2016. Only abstract of the study was published in Blood journal supplement issue in December 2016 and only abstract is available online (Google scholar).

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Author notes

  1. D Modi and A Deol: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Oncology, Karmanos Cancer Institute/Wayne State University, Detroit, MI, USA

    D Modi

  2. Department of Oncology, Blood and Marrow Stem Cell Transplant Program, Karmanos Cancer Institute/Wayne State University, Detroit, MI, USA

    A Deol, L Ayash, A Alavi, D Bhutani, V Ratanatharathorn & J P Uberti

  3. Department of Oncology, Biostatistics Core, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA

    S Kim

  4. Department of Oncology, Wayne State University, Detroit, MI, USA

    M Ventimiglia

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Modi, D., Deol, A., Kim, S. et al. Age does not adversely influence outcomes among patients older than 60 years who undergo allogeneic hematopoietic stem cell transplant for AML and myelodysplastic syndrome. Bone Marrow Transplant 52, 1530–1536 (2017). https://doi.org/10.1038/bmt.2017.182

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