Age alone should not limit access to stem cell transplants for patients with MDS
Patients with myelodysplastic syndrome (MDS) age 66 to 74 years did as well with stem cell transplantation as patients age 60 to 65 years. This research was presented at the 2013 American Society of Hematology (ASH) Annual Meeting, December 7-10, 2013, in New Orleans, Louisiana.
MDS leads to ineffective production of red blood cells in the bone marrow. In some cases, this can progress to bone marrow failure and severe anemia. MDS is diagnosed more frequently in older adults, with a mean age of 71 years at diagnosis. Stem cell transplantation is the only treatment that has the potential to cure MDS, but many patients are not healthy enough to undergo the procedure.
"This is good evidence that age alone should not limit who should get a transplant for MDS," said Gregory Abel, MD, MPH, a medical oncologist at the Dana-Farber Cancer Institute, Boston, Massachusetts. "Calendar age is less important than other measures, such as whether a patient is physically fit enough to [survive] a transplant, has a lot of comorbidities, and what his or her performance status is." Abel and colleagues studied the records of 67 Dana-Farber patients aged 60 to 74 who received reduced-intensity conditioning mini-transplants. No statistically significant differences were found in overall survival at 4 years or in 4-year survival without disease progression when recipients age 60 to 65 years were compared with recipients older than 66 years.
Patients in the two age groups also had comparable rates of cumulative incidence of relapse and comparable rates of death not caused by disease relapse. The authors used components of the revised international prognostic scoring system (IPSS-R) to create a method for calculating the risk score to predict 4-year overall survival at time of transplantation. Age was not a significant predictor of overall survival in the two multivariate models. One multivariate model included the IPSS-R and the other included the new score.
Abel said that the study findings "are good news, since patients with MDS tend to be elderly and this is the only curative treatment at the moment for this disease."