Blood, Marrow Transplantation With Cyclophosphamide May Improve Survival
Nonmyeloablative blood or marrow transplantation with post-transplantation cyclophosphamide has encouraging survival outcomes in older adults.
Nonmyeloablative (NMA), related HLA-haploidentical blood or marrow transplantation (haplo-BMT) with post-transplantation cyclophosphamide has encouraging safety and survival outcomes in older adults, a new study published in the Journal of Clinical Oncology has shown.
For the study, researchers from Johns Hopkins University in Baltimore, MD, sought to evaluate the impact of age on NMA haplo-BMT outcomes in patients aged 50 to 75 years.
Researchers performed a retrospective analysis of 271 patient aged 50 to 75 years with hematologic malignancies who received NMA, T-cell-replete haplo-BMT followed by high-dose cyclophosphamide.
Results showed that during a median follow-up of 4 years, the 3-year progression-free survival probabilities for patients in their 50s, 60s, and 70s were 39%, 35%, and 33%, respectively. The 3-year overall survival probabilities were 48%, 45%, and 44%, respectively.
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Looking at specific malignancies, researchers found that the 3-year progression-free survival probabilities were 40% in acute myeloid leukemia, 39% in aggressive non-Hodgkin lymphoma, and 37% in indolent or mantle-cell lymphoma.
In regard to safety, older age was significantly associated with a higher risk of grade 2 to 4 acute graft-versus-host disease.
"In patients otherwise fit for BMT, the results support consideration of this approach despite advanced age," the authors write.
- Kasamon YL, Bolanos-Meade J, Prince GT, et al. Outcomes of nonmyeloablative HLA-haploidentical blood or marrow transplantation with high-dose post-transplantation cyclophosphamide in older adults. J Clin Oncol. 2015. [epub ahead of print]. doi: 10.1200/JCO.2014.60.4777.