Researchers analyzing 313 patients over age 70 (median age 72 years) whose transplant outcomes were reported to the registry of the European Society for Blood and Marrow Transplantation (EBMT) found that careful selection of patients can significantly improve hematopoietic cell transplantation (HCT) outcomes. This retrospective analysis included patients with myelodysplastic syndromes (MDS) and secondary acute myeloid leukemia (sAML), with patient ages ranging from 70-78 years.
Transplants were performed between 2000 and 2013. The researchers noted that during 2000-2004, only 16 patients received HCT, and in 2011-2013, the number increased to 181.
Three-year overall survival (OS) of the entire cohort was 34%. However, patients with a good Karnofsky performance status and sero-negativity for cytomegalovirus (CMV) achieved 3-year estimated OS of 43% (p=0.01) and 46% (p=0.002), respectively. Conditioning regimen intensity and age did not significantly affect survival.
The researchers concluded that after careful patient selection, allogeneic HCT can be offered to patients older than 70 years with MDS.