Survival of patients ≥60 years undergoing ex vivo CD34+ selected reduced-intensity hematopoietic cell transplantation (HCT) was comparable to that of patients <60 years, according to research presented at ASH. The retrospective single-center study also found a difference in the type of toxicities by age that may be attributed to the GVHD prophylactic regimen.
Lead author Dr. Gunjan Shah of the Memorial Sloan Kettering Cancer Center reported on the study of 80 patients ≥60 years (median age 64, range 60-73) and 120 patients <60 years (median age 19, range 15-59) transplanted between 2006 and 2012 using ex vivo CD34+ selected grafts.
One-year overall survival (OS) was comparable in the ≥60 and <60 age cohorts: 70% vs. 78%, respectively (p=0.07). Non-relapse mortality (NRM) at 1-year was also comparable: 23% vs. 13%, respectively (p=0.38).
The median number of toxicities at day 100 was 6 in both age cohorts. Overall survival was not significantly different in patients ≥60 with more than the median toxicities compared to patients with less than the median toxicities, and when compared to patients <60 years (p=0.65).
Patients ≥60 had a higher risk of neurologic [HR 2.63 (1.45 to 4.78), p=0.001] and cardiovascular [HR 1.65 (1.04 to 2.63), p=0.03] toxicities, but lower risk of oral/ gastrointestinal [HR 0.58 (0.41 to 0.83), p=0.003] compared to <60 patients.
The researchers concluded that the comparable OS, NRM, and the number of toxicities in the two age cohorts may have been due to the absence of methotrexate and calcineurin inhibitors in this study.