title: Relationships between hematological recovery and overall survival in older adults undergoing allogeneic bone marrow transplantation.
abstract: OBJECTIVE
  The advancement of hematopoietic stem cell transplantation techniques and the increase in frequency of hematological malignancy in older patients are expected to expand the indications to include more elderly patients. We investigated the problem of allogeneic bone marrow transplantation (allo-BMT) in patients over 40 years old.
  
  
  METHODS
  We retrospectively analyzed 21 consecutive patients (13 males and 8 females) over 40 years old who underwent allo-BMT at our center during the past 12 years.
  
  
  RESULTS
  The patients had a median age of 46 years, and 5 patients were over 50 years old. There were 8 cases of acute myelogenous leukemia (AML), 5 cases of acute lymphocytic leukemia (ALL), 6 cases of chronic myelogenous leukemia (CML) and 2 cases of myelodysplastic syndrome (MDS). The 3-year overall survival rate was 43.0%. Overall survival was associated with recovery of platelets in less than 30 days and recovery of neutrophil counts in less than 15 days. We did not observe any severe graft-versus-host disease (GVHD) or regimen-related toxicities. Twelve patients died of transplantation-related diseases.
  
  
  CONCLUSIONS
  A faster recovery of the neutrophil and platelet counts was significantly associated with overall survival. Decreasing transplantation-related death, particularly by infection control, in allo-BMT in patients over age 40 is an important problem.
authors.affiliation: Department of Transfusion Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tabata
authors.forename: Shunro
authors.initials: S
authors.lastname: Kai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Satake
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wakae
authors.forename: Akinari
authors.initials: A
authors.lastname: Toda
authors.forename: Meishu
authors.initials: M
authors.lastname: Chin
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nishioka
authors.forename: Hidehisa
authors.initials: H
authors.lastname: Tanaka
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Itsukuma
authors.forename: Masao
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Masaya
authors.initials: M
authors.lastname: Okada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takatsuka
authors.forename: Mahito
authors.initials: M
authors.lastname: Misawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hara
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D010976:Platelet Count; D012189:Retrospective Studies