Does younger donor age affect the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies beneficially?

J. Mehta*, L. I. Gordon, M. S. Tallman, J. N. Winter, A. O. Evens, O. Frankfurt, S. F. Williams, D. Grinblatt, L. Kaminer, R. Meagher, S. Singhal

*Corresponding author for this work

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Sixty three patients aged 27-66 years (median 52) were allografted from HLA-matched sibling (n = 47), 10 of 10 allele-matched unrelated (n = 19), or one-antigen/allele-mismatched (n = 7) donors aged 24-69 years (median 46) after a conditioning regimen comprising 100mg/m2 melphalan. Cyclophosphamide (50mg/kg) was also administered to patients who had not been autografted previously. Cyclosporine or tacrolimus, and mycophenolate mofetil were administered to prevent graft-versus-host disease (GVHD). The 2-year cumulative incidences of relapse and TRM were 55 and 24% respectively, and 2-year probabilities of overall survival (OS) and disease-free survival (DFS) were 36 and 21%, respectively. Poor performance status, donor age >45 years and elevated lactate dehydrogenase (LDH) increased the risk of treatment-related mortality (TRM), refractory disease and donor age >45 years increased the risk of relapse, and OS and DFS were adversely influenced by refractory disease, poor performance status, increased LDH, and donor age >45 years. Our data suggest that younger donor age is associated with better outcome after sub-myeloablative allogeneic hematopoietic stem cell transplantation (HSCT) for hematologic malignancies due to lower TRM and relapse. This finding raises the question of whether a young 10-allele-matched unrelated donor is superior to an older matched sibling donor in patients where the clinical situation permits a choice between such donors.

Original languageEnglish (US)
Pages (from-to)95-100
Number of pages6
JournalBone Marrow Transplantation
Volume38
Issue number2
DOIs
StatePublished - Jul 2 2006

Keywords

  • Age
  • Allograft
  • Relapse

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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