•  
  •  
 

Authors

Berro Mariano, HSCT Unit, Hospital Universitario Austral, Pilar, ArgentinaFollow
Nelson Hamerschlak, HSCT Unit, Hospital Israelita Albert Einstein, San Pablo, Brazil
Milovic Vera, HSCT Unit, Hospital Aleman, Buenos Aires, Argentina
Castro Belen, HSCT Unit, Hospital Privado de Cordoba, Cordoba, Argentina
García P. Andres, HSCT Unit, Hospital Privado de Cordoba, Cordoba, Argentina
Ferini Gonzalo, HSCT Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Real J. Jos, HSCT Unit, Hospital Aleman, Buenos Aires, Argentina
Vitriu Adriana, HSCT Unit, Instituto Alexander Fleming, Buenos Aires, Argentina
Gimenez C. Alberto, HSCT Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Bendek Georgina, HSCT Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Yantorno Sebastian, HSCT Unit, Hospital Italiano La Plata, La Plata, Argentina
Martinez R. Juliana, HSCT Unit, FUNDALEU, Buenos Aires, Argentina
Saslavsky Martin, HSCT Unit, CETRAMOR, Rosario, Argentina
Jarchum Sol, HSCT Unit, Sanatorio Allende, Cordoba, Argentina
Cerutti Amalia, HSCT Unit, Sanatorio Britanico, Rosario, Argentina
Correa da S. Cinthya, HSCT Unit, Hospital Israelita Albert Einstein, San Pablo, Brazil
Rodrigues Morgani, HSCT Unit, Hospital Israelita Albert Einstein, San Pablo, Brazil
Riera Leandro, HSCT Unit, CEMIC, Buenos Aires, Argentina
Arbelbide Jorge, HSCT Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Kusminsky Gustavo, HSCT Unit, Hospital Universitario Austral, Pilar, Argentina
Basquiera A. Lisa, HSCT Unit, Hospital Privado de Cordoba, Cordoba, Argentina

Abstract

Background and objectives: Allogeneic stem cell transplantation (Allo-SCT) in elderly patients is a growing practice. We aimed to determine the graft-versus-host disease (GVHD) relapse-free survival (GRFS) in patients ≥65 years who underwent Allo-SCT in two countries from Latin America. Patients and methods: We performed a retrospective analysis of patients ≥65 years who underwent Allo-SCT in Argentina and Brazil from 2007 to 2019. Results: Ninety-eight patients were evaluated, with primary diagnoses of acute myeloid leukemia and myelodysplastic syndrome; 30% of patients had a hematopoietic cell transplant-comorbidity index (HCT-CI) score ≥3 and 49% were in complete remission. Donor types included matched sibling (n ¼ 41), matched unrelated (n ¼ 31), and haploidentical (HID; n ¼ 26) donors. The conditioning regimen was myeloablative in 28 patients (14 busulfan pharmacokinetically [PK]-guided) and reduced-intensity in 70 patients. The two-year non-relapse mortality (NRM) was 29%, with a higher NRM in melphalan-based compared to other conditionings (51% vs. 33%, p ¼ 0.02). The two-year relapse rate was 24%, with a reduction in PK-guided busulfan (0% vs. 28%, p ¼ 0.03). The two-year overall survival (OS) and GRFS was 52% and 38%, respectively, with a significant reduction in GRFS in HCT-CI ≥3 (27% vs. others 42%, p ¼ 0.02) and donors ≥40 years (29% vs.55%, p ¼ 0.02). These variables remained significantly associated with GRFS after multivariate analysis. Conclusion: In this cohort of elderly patients from Argentina and Brazil undergoing Allo-SCT, donor age and comorbidities significantly influenced GRFS. The role of the conditioning regimen in this population deserves further investigation.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Share

COinS