What the internist should know about stem cell transplant in the elderly patient

Eur J Intern Med. 2018 Dec:58:43-47. doi: 10.1016/j.ejim.2018.06.018. Epub 2018 Jun 28.

Abstract

Most hematological malignancies are increasing in frequency with age. Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapeutic option for patients with malignant and non-malignant hematological diseases. The treatment of elderly patients with advanced hematological malignancies has expanded to include reduced intensity conditioning allo-HCT. Physicians increasingly refer older patients for allo-HCT due to more experience and improved supportive care in allo-HCT. This review article discusses the available data regarding the feasibility, tolerability, toxicity, and effectiveness of allo-HCT in different hematological diseases in the elderly. Over the past decade, utilization and survival after allo-HCT have increased in patients ≥70 years. Selected adults ≥70 years with hematological diseases should be evaluated for transplantation.

Keywords: Conditioning regimen; Donor choice; Elderly patients; Geriatric assessment; Hematopoietic stem cell transplantation.

Publication types

  • Review

MeSH terms

  • Aged
  • Comorbidity
  • Geriatric Assessment
  • Hematologic Neoplasms / therapy*
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cell Transplantation / mortality
  • Humans
  • Immunotherapy
  • Transplantation Conditioning / methods*
  • Transplantation, Homologous / methods