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Published in: International Journal of Hematology 3/2012

01-03-2012 | Original Article

Prognostic factors in patients aged 50 years or older undergoing allogeneic hematopoietic stem cell transplantation for hematologic malignancy

Authors: Hirotaka Takasaki, Masatsugu Tanaka, Takayoshi Tachibana, Ayumi Numata, Katsumichi Fujimaki, Rika Sakai, Shin Fujisawa, Naoto Tomita, Hiroyuki Fujita, Atsuo Maruta, Yoshiaki Ishigatsubo, Heiwa Kanamori

Published in: International Journal of Hematology | Issue 3/2012

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Abstract

We retrospectively analyzed patients aged ≥ 50 years with hematologic malignancies who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) to identify preoperative variables predicting the outcome. There were 71 patients with a median age of 57 years (range: 50–63 years) who had acute leukemia (n = 53) or myelodysplastic syndrome (n = 18). Myeloablative conditioning was done in 35 patients and 36 patients had reduced-intensity conditioning. The 5-year overall survival rate (OS), cumulative relapse rate, and non-relapse mortality rate (NRM) were 45, 24, and 33%, respectively. According to multivariate analysis, high-risk disease (HR 3.50, 95% CI 1.43–8.56, P = 0.006), a hematopoietic cell transplantation comorbidity index (HCT-CI) score ≥3 (HR 4.41, 95% CI 1.31–14.77, P = 0.016), and an HLA-mismatched unrelated donor (HR 4.03, 95% CI 1.46–11.10, P = 0.007) were significant predictors of worse OS. High-risk disease was also significantly associated with a higher cumulative relapse rate (HR 4.59, 95% CI 0.94–6.92, P = 0.065). Furthermore, an HCT-CI score ≥3 (HR 3.02, 95% CI 1.01–20.78, P = 0.048) and an HLA-mismatched unrelated donor (HR 3.02, 95% CI 1.04–8.74, P = 0.042) were risk factors for NRM. These results suggest that the disease risk, HCT-CI score, and donor type/histocompatibility are prognostic factors for elderly patients, while the conditioning regimen and age are not predictors.
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Metadata
Title
Prognostic factors in patients aged 50 years or older undergoing allogeneic hematopoietic stem cell transplantation for hematologic malignancy
Authors
Hirotaka Takasaki
Masatsugu Tanaka
Takayoshi Tachibana
Ayumi Numata
Katsumichi Fujimaki
Rika Sakai
Shin Fujisawa
Naoto Tomita
Hiroyuki Fujita
Atsuo Maruta
Yoshiaki Ishigatsubo
Heiwa Kanamori
Publication date
01-03-2012
Publisher
Springer Japan
Published in
International Journal of Hematology / Issue 3/2012
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-012-1009-x

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