New research presented at the BMT Tandem Meetings shows that patients aged 70 years and older can have comparable hematopoietic cell transplantation (HCT) outcomes to those of younger patients and that comorbidities and disease risks, not age, should be used to evaluate potential candidates.
In this study of 1,637 consecutive non-myeloablative transplants, researchers compared outcomes of recipients ≥70 years old (n=101) to those in 4 younger age groups (Table 1). Patients aged ≥70 years had similar comorbidity burden and disease risks compared to younger patients.
When adjusted for risk factors, 2-year rates of non-relapse mortality, relapse and overall and progression free survival for patients aged ≥70 years were similar to those observed among patients in younger age groups (Table 1).
| Age – Years | OS | PFS | Relapse | NRM |
| 20-39 | 66% | 46% | 34% | 18% |
| 40-49 | 62% | 52% | 28% | 20% |
| 50-59 | 53% | 42% | 35% | 23% |
| 60-69 | 56% | 45% | 32% | 22% |
| 70-79 | 55% | 46% | 35% | 19% |
In a multivariate analysis, patients aged 20-39 years experienced significantly less NRM and overall mortality than those in other age groups. However, those risks were comparable among the remaining 4 age groups. Patients 70 years or older had comparable comorbidity burden and disease risk before transplant and similar outcomes after transplant when compared to patients as young as 40-49 years.
The researchers concluded that “comorbidities and disease risks should be used when assessing patients in their 8th or even 9th decades of age for transplant eligibility.” They also noted that additional research on the role of geriatric assessment may strengthen future outcome predictions.
Sorror ML, et al. Biol Blood Marrow Transplant