title: Allogeneic Stem Cell Transplantation for Patients Age ≥ 70 Years with Myelodysplastic Syndrome: A Retrospective Study of the MDS Subcommittee of the Chronic Malignancies Working Party of the EBMT.
abstract: In this retrospective analysis we evaluated the outcome of 313 patients aged ≥ 70 years in the registry of the European Group for Blood and Marrow Transplantation with myelodysplastic syndrome (MDS; n = 221) and secondary acute myeloid leukemia (n = 92) who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from related (n = 79) or unrelated (n = 234) donors. Median age at HSCT was 72 years (range, 70 to 78). Conditioning regimen was nonmyeloablative (n = 54), reduced intensity (n = 207), or standard intensity (n = 52). Allogeneic HSCT for MDS patients ≥ 70 years was increasingly performed over time. Although during 2000 to 2004 only 16 patients received HSCT, during 2011 to 2013 the number of transplantations increased to 181. The cumulative incidence of nonrelapse mortality at 1 year and relapse at 3 years was 32% and 28%, respectively, with a 3-year overall survival rate of 34%. Good performance, determined by Karnofsky performance status, and recipients' seronegativity for cytomegalovirus was associated with 3-year estimated overall survival rates of 43% (P = .01) and 46% (P = .002), respectively. Conditioning intensity did not impact survival. After careful patient selection, allogeneic HSCT can be offered to patients older than 70 years with MDS.
authors.affiliation: Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: s.heidenreich@uke.de.
authors.forename: Silke
authors.initials: S
authors.lastname: Heidenreich
authors.affiliation: Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Netherlands.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Ziagkos
authors.affiliation: Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Netherlands; DKMS, German Bone Marrow Donor Center, Germany.
authors.forename: Liesbeth C
authors.initials: LC
authors.lastname: de Wreede
authors.affiliation: EBMT Data Office, University Medical Center, Leiden, Netherlands.
authors.forename: Anja
authors.initials: A
authors.lastname: van Biezen
authors.affiliation: Department of Medicine, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Finke
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Platzbecker
authors.affiliation: Hematology and Oncology, University of Leipzig, Leipzig, Germany.
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
authors.affiliation: Department of Internal Medicine, University Medical Center, Wuerzburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.affiliation: Department of Internal Medicine II, University of Tübingen Medical Center, Tübingen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Bethge
authors.affiliation: Center for Hematopoietic Cell Transplantation, DKD Helios Klinik, Wiesbaden, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schleuning
authors.affiliation: Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, Essen, Germany.
authors.forename: Dietrich W
authors.initials: DW
authors.lastname: Beelen
authors.affiliation: Department of Internal Medicine III, Hematopoietic Cell Transplantation, Ludwig-Maximilians-University Hospital of Munich-Grosshadern, Munich, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Tischer
authors.affiliation: Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
authors.affiliation: Hematology, Oncology and Stem Cell Transplantation, Asklepios Hospital St Georg, Hamburg, Germany.
authors.forename: Bertram
authors.initials: B
authors.lastname: Glass
authors.affiliation: Department of Hematology, University Hospital Gasthuisberg Leuven, Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Maertens
authors.affiliation: Hematology Department, University Hospital Marques de Valdecilla, Santander, Spain.
authors.forename: Lucrecia
authors.initials: L
authors.lastname: Yáñez
authors.affiliation: Laboratory of Hematology, GIGA-I3, University of Liège CHU Sart-Tilman, Liège, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Beguin
authors.affiliation: Division of Hematology, Medical University of Graz, Graz, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Sill
authors.affiliation: Department of Medicine, University of Cologne, Cologne, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Scheid
authors.affiliation: Department of Hematology/Oncology, University of Münster, Münster, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Stelljes
authors.affiliation: Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
authors.forename: Arnold
authors.initials: A
authors.lastname: Ganser
authors.affiliation: Department of Hematology, Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Zachée
authors.affiliation: Department of Hematology, A.Z. Sint-Jan, Brugge, Belgium.
authors.forename: Dominik
authors.initials: D
authors.lastname: Selleslag
authors.affiliation: Department of Tumor Immunology, Nijmegen Center for Molecular Life Sciences, Radboud University of Nijmegen Medical Centre, Nijmegen, Netherlands.
authors.forename: Theo
authors.initials: T
authors.lastname: de Witte
authors.affiliation: Hématologie-Transplantation, Saint-Louis Hospital, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Robin
authors.affiliation: Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
mesh_terms: D000368:Aged; D003587:Cytomegalovirus / Q000276:immunology; D005060:Europe; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D017567:Karnofsky Performance Status; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000379:methods* / Q000401:mortality; D014184:Transplantation, Homologous
keywords: AML; Acute myeloid leukemia; Age; CMV; EBMT; HSCT; Karnofsky performance status; MDS; Myelodysplastic syndrome