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Feasibility of allogeneic hematopoietic stem cell transplantation in advanced age

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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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Acknowledgements

Thanks to all patients and their families included in the study and to all healthcare staff involved.

Author information

Author notes

  1. Enrique Maria Ocio and Arancha Bermudez Rodriguez contributed equally to this work.

Authors and Affiliations

  1. Hematology Department, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain

    Sara Fernandez-Luis, Juan Manuel Cerezo Martin, Lucrecia Yañez San Segundo, Miriam Sanchez Escamilla, Noemi Fernandez-Escalada, Jose Alvaro Calvo Sanchez, Sergio Fernandez Garcia, Juan Jose Dominguez-Garcia, Mercedes Colorado Araujo, Monica Lopez-Duarte, Guillermo Martin-Sanchez, Andres Insunza Gaminde, Jose Iñigo Romon Alonso, Rocio Lobeira Rubio, Enrique Maria Ocio & Arancha Bermudez Rodriguez

  2. Hematology Department, Hospital Universitario Basurto, Bilbao, Spain

    David Gomez Lamas

  3. Hematology Department, Hospital Sierrallana, Torrelavega, Spain

    Juan Manuel Mora Barrios

  4. University of Cantabria, Santander, Spain

    Lucrecia Yañez San Segundo, Enrique Maria Ocio & Arancha Bermudez Rodriguez

  5. Banco de Sangre y Tejidos de Cantabria, Santander, Spain

    Jose Luis Arroyo Rodriguez

  6. Hematology Department, Hospital Miguel Servet, Zaragoza, Spain

    Beatriz Rueda Ciller

  7. Hematology Department, Hospital San Pedro, Logroño, Spain

    Mar Hermosilla Fernandez

  8. Hematology Department, Hospital San Jorge, Huesca, Spain

    Victor Marco Betes

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  1. Sara Fernandez-Luis
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Contributions

LYS and ABR designed the study. SFL, DGL, JMCM, JMMB, JACL, SFG and JJDG collected patient data. SFL performed the statistical analysis. SFL, LYS, MSE, EMO and ABR interpreted results. SFL and ABR wrote the manuscript. All authors were in charge of the patients and critically reviewed and approved the final manuscript.

Corresponding author

Correspondence to Sara Fernandez-Luis.

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Competing interests

No funding was received to assist with the preparation of this manuscript. A non-financial grant was received from the GETH-TC (Grupo Español de Trasplante Hematopoyético y Terapia Celular) to help write the manuscript.

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Fernandez-Luis, S., Gomez Lamas, D., Cerezo Martin, J.M. et al. Feasibility of allogeneic hematopoietic stem cell transplantation in advanced age. Ann Hematol 103, 583–591 (2024). https://doi.org/10.1007/s00277-023-05521-x

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