Article (Scientific journals)
Increasing use of allogeneic hematopoietic cell transplantation in patients aged 70 years and older in the United States.
Muffly, Lori; Pasquini, Marcelo C.; Martens, Michael et al.
2017In Blood, 130 (9), p. 1156-1164
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Keywords :
Aged; Cohort Studies; Demography; Female; Hematopoietic Stem Cell Transplantation/mortality/utilization; Humans; Male; Multivariate Analysis; Prognosis; Time Factors; Transplantation, Homologous/mortality; Treatment Outcome; United States
Abstract :
[en] In this study, we evaluated trends and outcomes of allogeneic hematopoietic cell transplantation (HCT) in adults >/=70 years with hematologic malignancies across the United States. Adults >/=70 years with a hematologic malignancy undergoing first allogeneic HCT in the United States between 2000 and 2013 and reported to the Center for International Blood and Marrow Transplant Research were eligible. Transplant utilization and transplant outcomes, including overall survival (OS), progression-free survival (PFS), and transplant-related mortality (TRM) were studied. One thousand one hundred and six patients >/=70 years underwent HCT across 103 transplant centers. The number and proportion of allografts performed in this population rose markedly over the past decade, accounting for 0.1% of transplants in 2000 to 3.85% (N = 298) in 2013. Acute myeloid leukemia and myelodysplastic syndromes represented the most common disease indications. Two-year OS and PFS significantly improved over time (OS: 26% [95% confidence interval (CI), 21% to 33%] in 2000-2007 to 39% [95% CI, 35% to 42%] in 2008-2013, P < .001; PFS: 22% [16% to 28%] in 2000-2007 to 32% [95% CI, 29% to 36%] in 2008-2013, P = .003). Two-year TRM ranged from 33% to 35% and was unchanged over time (P = .54). Multivariable analysis of OS in the modern era of 2008-2013 revealed higher comorbidity by HCT comorbidity index >/=3 (hazard ratio [HR], 1.27; P = .006), umbilical cord blood graft (HR, 1.97; P = .0002), and myeloablative conditioning (HR, 1.61; P = .0002) as adverse factors. Over the past decade, utilization and survival after allogeneic transplant have increased in patients >/=70 years. Select adults >/=70 years with hematologic malignancies should be considered for transplant.
Research center :
GIGA-I3 - Giga-Infection, Immunity and Inflammation - ULiège
Disciplines :
Hematology
Author, co-author :
Muffly, Lori
Pasquini, Marcelo C.
Martens, Michael
Brazauskas, Ruta
Zhu, Xiaochun
Adekola, Kehinde
Aljurf, Mahmoud
Ballen, Karen K.
Bajel, Ashish
Baron, Frédéric  ;  Université de Liège - ULiège > GIGA-R : Hématologie
Battiwalla, Minoo
Beitinjaneh, Amer
Cahn, Jean-Yves
Carabasi, Mathew
Chen, Yi-Bin
Chhabra, Saurabh
Ciurea, Stefan
Copelan, Edward
D'Souza, Anita
Edwards, John
Foran, James
Freytes, Cesar O.
Fung, Henry C.
Gale, Robert Peter
Giralt, Sergio
Hashmi, Shahrukh K.
Hildebrandt, Gerhard C.
Ho, Vincent
Jakubowski, Ann
Lazarus, Hillard
Luskin, Marlise R.
Martino, Rodrigo
Maziarz, Richard
McCarthy, Philip
Nishihori, Taiga
Olin, Rebecca
Olsson, Richard F.
Pawarode, Attaphol
Peres, Edward
Rezvani, Andrew R.
Rizzieri, David
Savani, Bipin N.
Schouten, Harry C.
Sabloff, Mitchell
Seftel, Matthew
Seo, Sachiko
Sorror, Mohamed L.
Szer, Jeff
Wirk, Baldeep M.
Wood, William A.
Artz, Andrew
More authors (41 more) Less
Language :
English
Title :
Increasing use of allogeneic hematopoietic cell transplantation in patients aged 70 years and older in the United States.
Publication date :
2017
Journal title :
Blood
ISSN :
0006-4971
eISSN :
1528-0020
Publisher :
American Society of Hematology, Washington, United States - District of Columbia
Volume :
130
Issue :
9
Pages :
1156-1164
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 13 November 2017

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