PURPOSE: To evaluate outcomes of ablative allogeneic hematopoietic cell transplantation (HCT) in older patients with hematologic malignancies. PATIENTS AND METHODS: We treated 52 patients from 1979 to 2002 with a median age of 62.8 years (range, 60.1 to 67.8 years) using ablative preparative regimens followed by allogeneic HCT from sibling donors. Diagnoses included myelodysplastic syndrome (MDS; n = 35), chronic myeloid leukemia (CML; n = 8), acute myeloid leukemia (AML; n = 6), and other (n = 3). Conditioning regimens included cyclophosphamide (CY) and busulfan (BU) (67%), total-body irradiation and CY (21%), BU-fludarabine (10%), and CY (2%). RESULTS: Eighteen (35%) of 52 patients are alive at a median of 4.6 years (range, 0.8 to 9.1 years) after transplantation. Median overall survival (OS) and progression-free survival were 300 and 218 days, respectively. Three-year OS and relapse rates are estimated to be 34% and 24%, respectively. Nonrelapse mortality (NRM) rates at 100 days and 3 years are estimated to be 27% and 43%, respectively. Grade 3 to 4 acute graft-versus-host disease (GVHD) occurred in 20% of patients, and chronic extensive GVHD was described in 53% of patients. Fourteen (40%) of 35 patients with MDS are alive at a median of 2.8 years (range, 0.8 to 8.2 years). Four of six patients with CML in chronic or accelerated phase are alive at a median of 6.9 years (range, 4.1 to 9.1 years) after transplantation. None of the patients with AML, CML in blast crisis, or other diagnoses have survived. Patients who underwent transplantation after 1993 had improved survival. CONCLUSION: These data suggest that allogeneic HCT is feasible in selected patients > or = 60 years of age, although novel methods to reduce NRM while maintaining efficacy are needed.
PURPOSE: To evaluate outcomes of ablative allogeneic hematopoietic cell transplantation (HCT) in older patients with hematologic malignancies. PATIENTS AND METHODS: We treated 52 patients from 1979 to 2002 with a median age of 62.8 years (range, 60.1 to 67.8 years) using ablative preparative regimens followed by allogeneic HCT from sibling donors. Diagnoses included myelodysplastic syndrome (MDS; n = 35), chronic myeloid leukemia (CML; n = 8), acute myeloid leukemia (AML; n = 6), and other (n = 3). Conditioning regimens included cyclophosphamide (CY) and busulfan (BU) (67%), total-body irradiation and CY (21%), BU-fludarabine (10%), and CY (2%). RESULTS: Eighteen (35%) of 52 patients are alive at a median of 4.6 years (range, 0.8 to 9.1 years) after transplantation. Median overall survival (OS) and progression-free survival were 300 and 218 days, respectively. Three-year OS and relapse rates are estimated to be 34% and 24%, respectively. Nonrelapse mortality (NRM) rates at 100 days and 3 years are estimated to be 27% and 43%, respectively. Grade 3 to 4 acute graft-versus-host disease (GVHD) occurred in 20% of patients, and chronic extensive GVHD was described in 53% of patients. Fourteen (40%) of 35 patients with MDS are alive at a median of 2.8 years (range, 0.8 to 8.2 years). Four of six patients with CML in chronic or accelerated phase are alive at a median of 6.9 years (range, 4.1 to 9.1 years) after transplantation. None of the patients with AML, CML in blast crisis, or other diagnoses have survived. Patients who underwent transplantation after 1993 had improved survival. CONCLUSION: These data suggest that allogeneic HCT is feasible in selected patients > or = 60 years of age, although novel methods to reduce NRM while maintaining efficacy are needed.
Authors: Boglarka Gyurkocza; Rainer Storb; Barry E Storer; Thomas R Chauncey; Thoralf Lange; Judith A Shizuru; Amelia A Langston; Michael A Pulsipher; Christopher N Bredeson; Richard T Maziarz; Benedetto Bruno; Finn B Petersen; Michael B Maris; Edward Agura; Andrew Yeager; Wolfgang Bethge; Firoozeh Sahebi; Frederick R Appelbaum; David G Maloney; Brenda M Sandmaier Journal: J Clin Oncol Date: 2010-05-03 Impact factor: 44.544
Authors: Theo de Witte; David Bowen; Marie Robin; Luca Malcovati; Dietger Niederwieser; Ibrahim Yakoub-Agha; Ghulam J Mufti; Pierre Fenaux; Guillermo Sanz; Rodrigo Martino; Emilio Paolo Alessandrino; Francesco Onida; Argiris Symeonidis; Jakob Passweg; Guido Kobbe; Arnold Ganser; Uwe Platzbecker; Jürgen Finke; Michel van Gelder; Arjan A van de Loosdrecht; Per Ljungman; Reinhard Stauder; Liisa Volin; H Joachim Deeg; Corey Cutler; Wael Saber; Richard Champlin; Sergio Giralt; Claudio Anasetti; Nicolaus Kröger Journal: Blood Date: 2017-01-17 Impact factor: 22.113
Authors: D Modi; A Deol; S Kim; L Ayash; A Alavi; M Ventimiglia; D Bhutani; V Ratanatharathorn; J P Uberti Journal: Bone Marrow Transplant Date: 2017-09-04 Impact factor: 5.483
Authors: Ann A Jakubowski; Trudy N Small; James W Young; Nancy A Kernan; Hugo Castro-Malaspina; Katherine C Hsu; Miguel-Angel Perales; Nancy Collins; Christine Cisek; Michelle Chiu; Marcel R M van den Brink; Richard J O'Reilly; Esperanza B Papadopoulos Journal: Blood Date: 2007-08-23 Impact factor: 22.113