A new study has concluded that selecting an older blood cancer patient as a contender for stem cell transplantation does not depend solely on age.
The study summarized the results from a number of clinical trials of older patients who underwent mini allogeneic stem cell transplantation.
The study findings are published in Nov. 2 edition of The Journal of the American Medical Association.
Paper’s co-author, Mohamed Sorror said, “Allogeneic transplant is no longer obstructed by age.”
The research team found that rates of disease-progression-free and overall survival over five-years among those who had mini-transplant were 32% and 35% respectively. On dividing the patients in 3 age categories — 60 to 64, 65 to 69 and 70 to 75, researchers found similar survival rates in them, which suggested that tolerance of the mini-transplant had minimum dependence on age. They found that comorbidities and a higher cancer aggressiveness degree were the 2 risk factors that had impact on survival among older patients.
The authors wrote, “These findings are heartening with regard to relapse, given that the non-transplantation treatments brought poor outcomes, especially for patients with progressive lymphoma, fludarabine-refractory chronic lymphocytic leukemia or acute myeloid leukemia.”
The study involved 372 older patients enrolled in potential clinical trials at 18 collaborating cancer centers from Europe and U.S. between 1998 and 2008. The study patients received treatment for their myelogenous leukemia, myelodysplastic syndromes, multiple myeloma and lymphoma.
The researchers also examined rates of graft-vs.-host disease, hospitalization, relapse, and treatment toxicity to internal organs.
Previously the Hematopoietic Cell Transplant-specific Comorbidity Index (HCT-CI) was developed by Sorror and his team by investigating the links between mortality and single comorbidities after a stem cell transplant.
“Using HCT-CI allowed us to capture the significant role played by comorbidities in defining older patients’ survival,” he said.
Sorror said. “We have little knowledge about why the recommendation rate of elder patients to transplant is low or how outcomes of mini-transplant are compared to those of conventional treatments. We are planning to start a multicenter study designed to track patients from diagnosis time to find answers to both questions.”