Patients ≥ age 40 years undergoing autologous or allogeneic BMT have regimen-related mortality rates and event-free survivals comparable to patients < age 40 years

A. P. Rapoport, J. F. DiPersio, B. A. Martin, R. E. Duerst, P. A. Kouides, J. L. Liesveld, C. N. Abboud, C. H. Packman, S. W. Eberly, M. Sherman, M. A. Tanner, L. S. Constine, J. M. Rowe

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

To evaluate the safety and efficacy of marrow transplantation for older adults, the regimen-related mortality and event-free survival for patients ≥ 40 years were compared with those for patients < 40 years. Of 148 consecutive patients recieving autotransplants for lymphoma or Hodgkin's disease, 70 were < 40 years and 78 were ≥ 40 years at the time of time of transplant, including 40 who were ≥ 50 years and 12 who were ≥ 60 years. Eleven patients (16%) in the younger age group died from transplant-related complications compared with 4 (5%) in the older age group. The 4-year actuarial event-free survivals (EFS) for the younger and older age groups were 43% and 48%, respectively. After adjustment for covariates with prognostic significance, older age was marginally associated with improved event-free survival (P = 0.08). Of 92 consecutive patients undergoing allogeneic BMT during the same period, 62 patients were < 40 years and 30 patients were ≥ 40 years, including 8 patients ≥ 50 years, and 1 patient > 60 years. Non-relapse mortality (including deaths from GVHD) occurred in 28 of the younger patients (45%) and 9 of the older patients (30%). The 3-year actuarial EFS for the younger patients was 26% vs. 56% for the patients ≥ 40 years (P = 0.057). However, this difference was mainly due to the higher proportion of patients with CML and early-stage leukemia in the older age group. While older adults referred for transplantation may be selected, these data suggest that such patients exhibit treatment-related toxicity and event-free survival rates that are comparable to those of younger patients. Selection of patients on the basis of age alone should be discouraged.

Original languageEnglish (US)
Pages (from-to)523-530
Number of pages8
JournalBone Marrow Transplantation
Volume15
Issue number4
StatePublished - Jan 1 1995

Keywords

  • Mortality
  • Patient age
  • Regimen-related
  • Survival

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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