Relationships between hematological recovery and overall survival in older adults undergoing allogeneic bone marrow transplantation.
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.
Tabata
Masahiko
M
Department of Transfusion Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo.
Kai
Shunro
S
Satake
Atsushi
A
Wakae
Takeshi
T
Toda
Akinari
A
Chin
Meishu
M
Nishioka
Keisuke
K
Tanaka
Hidehisa
H
Itsukuma
Takeyoshi
T
Yamaguchi
Masao
M
Okada
Masaya
M
Takatsuka
Hiroyuki
H
Misawa
Mahito
M
Hara
Hiroshi
H
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