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Journal of Cancer Research and Clinical Oncology

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01-11-2014 | Original Article – Clinical Oncology

Allogeneic stem cell transplantation in patients above 55: suggestion for a further stratification of the HCT-CI

Authors: Christian Späth, Christoph Busemann, William H. Krüger

Published in: Journal of Cancer Research and Clinical Oncology | Issue 11/2014

Abstract

Introduction

Allogeneic stem cell transplantation (alloSCT) has become available for elderly patients or for patients with comorbidities by introduction of reduced-intense conditioning. Comorbidity-related prognosis after alloSCT can be estimated by the hematopoietic cell transplantation comorbidity index (HCT-CI).

Material and Methods

The charts from 85 patients who have undergone 90 alloSCTs between 1999 and 2011 were analysed. Most patients received a dose-reduced conditioning and a graft from an unrelated donor. Patients were stratified for age, HCT-CI, cGvHD versus no cGvHD, and a modified HCT-CI with a further split high-risk score.

Results

Age over 60 years did not affect the outcome. Manifestation of cGvHD improved the prognosis significantly. An additional stratification of the high-risk group of the HCT-CI revealed that even a fraction of these patients can have considerable benefit from an alloSCT. Furthermore, this high-risk collective could be clearly discriminated into two groups with different outcomes.

Conclusions

The investigation confirms that age is no absolute risk factor for alloSCT and demonstrates the heterogeneity of the high-risk group of the HCT-CI. A comprehensive investigation of an additional stratification is suggested. Furthermore, the authors encourage early withdrawal of immunosuppression, even in elderly patients and patients with comorbidities to permit graft-versus-leukaemia/lymphoma, since cGvHD is associated with a significantly better prognosis.

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Title: Allogeneic stem cell transplantation in patients above 55: suggestion for a further stratification of the HCT-CI
Authors: Christian Späth
Christoph Busemann
William H. Krüger
Publication date: 01-11-2014
Publisher: Springer Berlin Heidelberg
Published in: Journal of Cancer Research and Clinical Oncology / Issue 11/2014
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-014-1748-6

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Results

Conclusions

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