Allogeneic Hematopoietic Cell Transplantation in Patients aged 50 years or older with Severe Aplastic Anemia

C. Rice, D.J. Eikema, J.C.W. Marsh, C. Knol, K. Hebert, H. Putter, E. Peterson, H.-J. Deeg, C.J.M. Halkes, J. Pidala, P. Anderlini, J. Tischer, N. Kroger, A. McDonald, J.H. Antin, N.P.M. Schaap, M. Hallek, H. Einsele, V. Mathews, N. KapoorJ.J. Boelens, G.J. Mufti, V. Potter, R. Pefault de la Tour, M. Eapen, C. Dufour

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Abstract

We report on 499 patients with severe aplastic anemia aged ≥50 years who underwent hematopoietic cell transplantation (HCT) from HLA-matched sibling (n=275), or HLA-matched (8/8) unrelated donors (n=39187) between 2005 and 2016. The median age at HCT was 57.8 years; 16% of patients were 65-77 years old. Multivariable analysis confirmed higher mortality risks for patients with performance score less than 90% (HR 1.41 (1.03-1.92), p=0.03) and after unrelated donor transplantation (HR 1.47 (1-2.16), p=0.05). The 3-year probabilities of survival for patients with performance score 90-100 and less than 90 after HLA-matched sibling transplant were 66% (57-75%) and 57% (47-76%), respectively. The corresponding probabilities after HLA-matched unrelated donor transplantation were 57% (48-67%) and 48% (36-59%). Age at transplantation was not associated with survival but grade II-IV acute GVHD risks were higher for patients aged 65 years or older (sHR 1.7 (1.07-2.72), p=0.026). Chronic GVHD was lower with GVHD prophylaxis regimens calcineurin inhibitor (CNI) + methotrexate (sHR 0.52 (0.33-0.81), p=0.004) and CNI alone or other agents (sHR 0.27 (0.14-0.53), p
Original languageEnglish
JournalBIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Early online date5 Sept 2018
DOIs
Publication statusE-pub ahead of print - 5 Sept 2018

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