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• W2117984306 abstract "Allogeneic stem-cell transplantation (SCT) is a potentially curative approach for patients (pts) with hematological malignancies. However, elderly pts have often been deterred from this approach due to high risks of treatment-related complications and less chance of getting suitable donors. Umbilical cord blood transplantation with reduced-intensity conditioning (RI-UCBT) allowed extension of allogeneic SCT to a wider pt population including the elderly. However, there are only limited data on the feasibility and outcome in elderly pts. In this study, we report our experience with 63 pts aged 55 years old and older having RI-UCBT. The median age was 62 years (range, 55-79). Thirty-six pts were over 60, including 6 pts over 70. Diagnoses included AML (n = 20), ALL (n = 7), MDS (n = 8), ATL (n = 14), CML (n = 4), NHL (n = 7), MM (n = 1), and SAA (n = 2). The preparative regimen consisted of fludarabine (125 mg/m2) combined with melphalan (80 mg/m2) and 4 Gy total body irradiation for most of the patients (n = 60). Either cyclosporine alone (n = 37) or tacrolimus alone (n = 26) were employed as GVHD prophylaxis. Forty-eight pts engrafted with a median of 19 days (range, 11-53). Five pts died prior to engraftment. With a median follow-up of 116 days (range, 11-1092), 20 pts are alive and 43 have died; 32 of treatment-related causes (16 of infection, 7 of GVHD, 4 of IP, 2 of TMA, and 3 of others) and 12 of relapse. The probabilities of overall survival at 2-year after SCT were 32.8% (95 CI, 15-51%). Acute GVHD occurred in 31 pts, 22 of those were in grade II-IV. Pts aged 62 and older had an OS of only 16.1%, whereas pts younger than 62 years old had an OS of 48.5% (P = .008). There was a tendencies for ptsin standard risk group (acute leukemia in remission, CML AP, SAA, and untreated MDS) to have better OS of 54.5% than those in high risk group (all the rest, OS = 28.3%, P = .06), and for pts who had tacrolimus as GVHD prophylaxis (OS = 46.2%) than those with cyclosporine (OS = 23.7%, P = .09), although the differences were not statistically significant. When the pts aged 62 and older were analysed, tacrolimus group (n = 11) tended to have a greater chance to survive (OS=36.4%) than cyclosporine group (n = 11, OS=5.0%). In conclusion, RI-UCBT is feasible in elderly pts. Even within this group of pts, older age (62 years and older) is still an unfavorable factor for survival. Tacrolimus as GVHD prophylaxis may, however, have a potential to improve outcome for those in higher age range." @default.
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• W2117984306 date "2006-02-01" @default.
• W2117984306 modified "2023-09-26" @default.
• W2117984306 title "Hematopoietic stem-cell transplantation from unrelated umbilical cord blood in elderly patients (>54 years): Older age is no longer a contraindication when using reduced-intensity conditioning" @default.
• W2117984306 doi "https://doi.org/10.1016/j.bbmt.2005.11.032" @default.
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