Does younger donor age affect the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies beneficially?

J. Mehta, L. I. Gordon, M. S. Tallman, J. N. Winter, Andrew Evens, O. Frankfurt, S. F. Williams, D. Grinblatt, L. Kaminer, R. Meagher, S. Singhal

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Sixty three patients aged 27-66 years (median 52) were allografted from HLA-matched sibling (n = 47), 10 of 10 allele-matched unrelated (n = 19), or one-antigen/allele-mismatched (n = 7) donors aged 24-69 years (median 46) after a conditioning regimen comprising 100mg/m2 melphalan. Cyclophosphamide (50mg/kg) was also administered to patients who had not been autografted previously. Cyclosporine or tacrolimus, and mycophenolate mofetil were administered to prevent graft-versus-host disease (GVHD). The 2-year cumulative incidences of relapse and TRM were 55 and 24% respectively, and 2-year probabilities of overall survival (OS) and disease-free survival (DFS) were 36 and 21%, respectively. Poor performance status, donor age >45 years and elevated lactate dehydrogenase (LDH) increased the risk of treatment-related mortality (TRM), refractory disease and donor age >45 years increased the risk of relapse, and OS and DFS were adversely influenced by refractory disease, poor performance status, increased LDH, and donor age >45 years. Our data suggest that younger donor age is associated with better outcome after sub-myeloablative allogeneic hematopoietic stem cell transplantation (HSCT) for hematologic malignancies due to lower TRM and relapse. This finding raises the question of whether a young 10-allele-matched unrelated donor is superior to an older matched sibling donor in patients where the clinical situation permits a choice between such donors.

Original languageEnglish (US)
Pages (from-to)95-100
Number of pages6
JournalBone Marrow Transplantation
Volume38
Issue number2
DOIs
StatePublished - Jul 2 2006

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Hematopoietic Stem Cell Transplantation
Hematologic Neoplasms
Tissue Donors
Alleles
L-Lactate Dehydrogenase
Recurrence
Disease-Free Survival
Mortality
Siblings
Mycophenolic Acid
Unrelated Donors
Melphalan
Survival
Tacrolimus
Graft vs Host Disease
Cyclophosphamide
Cyclosporine
Therapeutics
Antigens
Incidence

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Mehta, J. ; Gordon, L. I. ; Tallman, M. S. ; Winter, J. N. ; Evens, Andrew ; Frankfurt, O. ; Williams, S. F. ; Grinblatt, D. ; Kaminer, L. ; Meagher, R. ; Singhal, S. / Does younger donor age affect the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies beneficially?. In: Bone Marrow Transplantation. 2006 ; Vol. 38, No. 2. pp. 95-100.
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abstract = "Sixty three patients aged 27-66 years (median 52) were allografted from HLA-matched sibling (n = 47), 10 of 10 allele-matched unrelated (n = 19), or one-antigen/allele-mismatched (n = 7) donors aged 24-69 years (median 46) after a conditioning regimen comprising 100mg/m2 melphalan. Cyclophosphamide (50mg/kg) was also administered to patients who had not been autografted previously. Cyclosporine or tacrolimus, and mycophenolate mofetil were administered to prevent graft-versus-host disease (GVHD). The 2-year cumulative incidences of relapse and TRM were 55 and 24{\%} respectively, and 2-year probabilities of overall survival (OS) and disease-free survival (DFS) were 36 and 21{\%}, respectively. Poor performance status, donor age >45 years and elevated lactate dehydrogenase (LDH) increased the risk of treatment-related mortality (TRM), refractory disease and donor age >45 years increased the risk of relapse, and OS and DFS were adversely influenced by refractory disease, poor performance status, increased LDH, and donor age >45 years. Our data suggest that younger donor age is associated with better outcome after sub-myeloablative allogeneic hematopoietic stem cell transplantation (HSCT) for hematologic malignancies due to lower TRM and relapse. This finding raises the question of whether a young 10-allele-matched unrelated donor is superior to an older matched sibling donor in patients where the clinical situation permits a choice between such donors.",
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Mehta, J, Gordon, LI, Tallman, MS, Winter, JN, Evens, A, Frankfurt, O, Williams, SF, Grinblatt, D, Kaminer, L, Meagher, R & Singhal, S 2006, 'Does younger donor age affect the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies beneficially?', Bone Marrow Transplantation, vol. 38, no. 2, pp. 95-100. https://doi.org/10.1038/sj.bmt.1705388

Does younger donor age affect the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies beneficially? / Mehta, J.; Gordon, L. I.; Tallman, M. S.; Winter, J. N.; Evens, Andrew; Frankfurt, O.; Williams, S. F.; Grinblatt, D.; Kaminer, L.; Meagher, R.; Singhal, S.

In: Bone Marrow Transplantation, Vol. 38, No. 2, 02.07.2006, p. 95-100.

Research output: Contribution to journalArticle

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T1 - Does younger donor age affect the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies beneficially?

AU - Mehta, J.

AU - Gordon, L. I.

AU - Tallman, M. S.

AU - Winter, J. N.

AU - Evens, Andrew

AU - Frankfurt, O.

AU - Williams, S. F.

AU - Grinblatt, D.

AU - Kaminer, L.

AU - Meagher, R.

AU - Singhal, S.

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N2 - Sixty three patients aged 27-66 years (median 52) were allografted from HLA-matched sibling (n = 47), 10 of 10 allele-matched unrelated (n = 19), or one-antigen/allele-mismatched (n = 7) donors aged 24-69 years (median 46) after a conditioning regimen comprising 100mg/m2 melphalan. Cyclophosphamide (50mg/kg) was also administered to patients who had not been autografted previously. Cyclosporine or tacrolimus, and mycophenolate mofetil were administered to prevent graft-versus-host disease (GVHD). The 2-year cumulative incidences of relapse and TRM were 55 and 24% respectively, and 2-year probabilities of overall survival (OS) and disease-free survival (DFS) were 36 and 21%, respectively. Poor performance status, donor age >45 years and elevated lactate dehydrogenase (LDH) increased the risk of treatment-related mortality (TRM), refractory disease and donor age >45 years increased the risk of relapse, and OS and DFS were adversely influenced by refractory disease, poor performance status, increased LDH, and donor age >45 years. Our data suggest that younger donor age is associated with better outcome after sub-myeloablative allogeneic hematopoietic stem cell transplantation (HSCT) for hematologic malignancies due to lower TRM and relapse. This finding raises the question of whether a young 10-allele-matched unrelated donor is superior to an older matched sibling donor in patients where the clinical situation permits a choice between such donors.

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