Clinical outcomes in allogeneic haematopoietic stem cell transplantation: A comparison between young and elderly patients. Observational study

Eur J Cancer Care (Engl). 2019 Sep;28(5):e13122. doi: 10.1111/ecc.13122. Epub 2019 Jun 30.

Abstract

Objectives: To analyse clinical outcomes comparing two age groups of patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT), and to identify risk factors associated with older patients' mortality.

Methods: In this retrospective study, the medical charts of all consecutive patients admitted in one hospital for allo-HSCT were reviewed. Overall survival (OS) and other outcomes were compared between patients aged up to 55 years (YG) and older than 55 (EG).

Results: From January 2007 to August 2014, 111 adult patients were admitted for allo-HSCT and were included 75 in the YG and 36 in the EG group. The OS rate at D+ 100 was 84% for YG individuals in contrast to 75% in the EG (p = 0.01), and 71% vs. 50% at one year after HSCT (p = 0.01) respectively. Therapy-related mortality (TRM) rates for the YG and EG were, respectively, 14% vs. 17% (p = 0.04) at D+ 100 and 17% vs. 32% (p = 0.04) at one year. Haploidentical donor type and active disease status significantly increased mortality risk in the EG (hazard ratio 2.42; p = 0.018; and 2.04; p = 0.033).

Conclusion: YG and EG have similar TRM rates early after allo-HSCT, but the elderly had higher TRM during the critical period from 100 days to one year.

Keywords: age; graft survival; graft vs host disease; haematopoietic stem cell transplantation; mortality; survival; survival analysis; transplantation conditioning.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Brazil / epidemiology
  • Female
  • Graft vs Host Disease / epidemiology*
  • Haplotypes
  • Hematologic Neoplasms / mortality
  • Hematologic Neoplasms / therapy*
  • Hematopoietic Stem Cell Transplantation / mortality*
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay
  • Leukemia, Myeloid, Acute / mortality
  • Leukemia, Myeloid, Acute / therapy
  • Lymphoma, Non-Hodgkin / mortality
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Middle Aged
  • Mortality*
  • Myelodysplastic Syndromes / mortality
  • Myelodysplastic Syndromes / therapy
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / mortality*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Prognosis
  • Proportional Hazards Models
  • Renal Replacement Therapy / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Tissue Donors
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult