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Fernandez-Luis S, Gomez Lamas D, Cerezo Martin JM, Mora Barrios JM, Yañez San Segundo L, Sanchez Escamilla M, Fernandez-Escalada N, Calvo Sanchez JA, Fernandez Garcia S, Dominguez-Garcia JJ, Colorado Araujo M, Lopez-Duarte M, Martin-Sanchez G, Insunza Gaminde A, Romon Alonso JI, Lobeira Rubio R, Arroyo Rodriguez JL, Rueda Ciller B, Hermosilla Fernandez M, Marco Betes V, Ocio EM, Bermudez Rodriguez A. Feasibility of allogeneic hematopoietic stem cell transplantation in advanced age. Ann Hematol 2024; 103:583-591. [PMID: 37923805 DOI: 10.1007/s00277-023-05521-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 10/25/2023] [Indexed: 11/06/2023]
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.
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Affiliation(s)
- Sara Fernandez-Luis
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain.
| | - David Gomez Lamas
- Hematology Department, Hospital Universitario Basurto, Bilbao, Spain
| | | | | | - Lucrecia Yañez San Segundo
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
- University of Cantabria, Santander, Spain
| | | | | | | | - Sergio Fernandez Garcia
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | | | | | - Monica Lopez-Duarte
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | | | - Andres Insunza Gaminde
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Jose Iñigo Romon Alonso
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Rocio Lobeira Rubio
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | | | | | | | | | - Enrique Maria Ocio
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
- University of Cantabria, Santander, Spain
| | - Arancha Bermudez Rodriguez
- Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
- University of Cantabria, Santander, Spain
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