Allogeneic hematopoietic stem cell transplantation in patients aged 60-79 years in Germany (1998-2018): a registry study

被引：0

作者：

Weller, Jan Frederic ^{[1
]}

Lengerke, Claudia ^{[1
]}

Finke, Juergen ^{[2
]}

Schetelig, Johannes ^{[3
]}

Platzbecker, Uwe ^{[4
]}

Einsele, Hermann ^{[5
]}

Schroeder, Thomas ^{[6
]}

Faul, Christoph ^{[1
]}

Stelljes, Matthias ^{[7
]}

Dreger, Peter ^{[8
]}

Blau, Igor W. ^{[9
]}

Wulf, Gerald ^{[10
]}

Tischer, Johanna ^{[11
]}

Scheid, Christoph ^{[12
,13
]}

Elmaagacli, Ahmet ^{[14
]}

Neidlinger, Helga ^{[15
]}

Flossdorf, Sarah ^{[15
,16
]}

Bornhaeuser, Martin

Bethge, Wolfgang

Fleischhauer, Katharina ^{[15
,17
]}

Kroeger, Nicolaus ^{[15
,18
]}

de Wreede, Liesbeth C. ^{[19
,20
]}

Christopeit, Maximilian ^{[1
]}

机构：

[1] Univ Hosp Tubingen, Dept Internal Med Hematol Oncol Clin Immunol & Rh, Tubingen, Germany

[2] Univ Freiburg, Univ Med Ctr Freiburg, Fac Med, Dept Hematol Oncol & Stem Cell Transplantat, Freiburg, Germany

[3] Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Internal Med 1, Dresden, Germany

[4] Leipzig Univ Hosp, Med Clin & Policlin 1, Hematol & Cellular Therapy, Leipzig, Germany

[5] Univ Hosp Wurzburg, Dept Internal Med 2, Wurzburg, Germany

[6] Univ Hosp Essen, West German Canc Ctr Essen, Dept Hematol & Stem Cell Transplantat, Essen, Germany

[7] Univ Hosp Munster, Dept Med A, Munster, Germany

[8] Heidelberg Univ, Dept Orthoped 5, Heidelberg, Germany

[9] Charite Univ Med Berlin, Med Clin, Berlin, Germany

[10] Univ Med Gottingen, Hematol & Med Oncol, Gottingen, Germany

[11] Ludwig Maximilians Univ Munchen, Internal Med 3, Hematol Oncol Stem Cell Transplantat, Munich, Germany

[12] Univ Cologne, Fac Med, Cologne, Germany

[13] Univ Cologne, Cologne Univ Hosp, Ctr Integrated Oncol Aachen Bonn Cologne Dusseldo, Cologne, Germany

[14] Asklepios Klin St Georg, Dept Hematol Oncol & Stem Cell Transplantat, Hamburg, Germany

[15] German Registry Stem Cell Transplantat, DRST, Ulm, Germany

[16] Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol IMIBE, Essen, Germany

[17] Univ Hosp Essen, Inst Expt Cellular Therapy, Essen, Germany

[18] Univ Med Ctr Hamburg Eppendorf, Dept Stem Cell Transplantat, Hamburg, Germany

[19] Leiden Univ, Med Ctr, Dept Biomed Data Sci, Leiden, Netherlands

[20] DKMS Clin Trials Unit, Dresden, Germany

来源：

REVISTA CHILENA DE LITERATURA | 2024年 / 109期

关键词：

D O I：

暂无

中图分类号：

I3/7 [各国文学];

学科分类号：

摘要：

Incidences of diseases treated with transplantation frequently peak at higher age. The contribution of age to total risk of transplantation has not been estimated amidst an aging society. We compare outcomes of 1,547 patients aged 70-79 years and 9,422 patients aged 60-69 years transplanted 1998-2018 for myeloid, lymphoid and further neoplasia in Germany. To quantify the contribution of population mortality to survival, we derive excess mortality based on a sex-, year- and agematched German population in a multistate model that incorporates relapse and graft -versus -host -disease (GvHD). Overall survival, relapse -free survival (RFS) and GvHD-free-relapse-free survival (GRFS) is inferior in patients aged 70-79 years, compared to patients aged 60-69 years, with 36% (95% Confidence Interval [CI]: 34-39%) versus 43% (41-44%), 32% (3035%) versus 36% (35-37%) and 23% (21-26%) versus 27% (26-28%) three years post -transplant (P<0.001). Cumulative incidences of relapse at three years are 27% (25-30%) for patients aged 70-79 versus 29% (29-30%) (60-69 years) (P=0.71), yet the difference in non -relapse mortality (NRM) (40% [38-43%] vs. 35% [34-36%] in patients aged 70-79 vs. 60-69 years) (P<0.001) translates into survival differences. Median OS of patients surviving >1 year relapse -free is 6.7 (median, 95% CI: 4.5-9.4, 70-79 years) versus 9 (8.4-10.1, 60-69 years) years since landmark. Three years after RFS of one year, excess NRM is 14% (95% CI: 12-18%) in patients aged 70-79 versus 12% [11-13%] in patients aged 60-69, while population NRM is 7% (6-7%) versus 3% (3-3%). Mortality for reasons other than relapse, GvHD, or age is as high as 27% (24-29%) and 22% (22-23%) four years after transplantation. In conclusion, survival amongst older patients is adequate after allogeneic stem cell transplantation.

引用

页码：431 / 443

页数：13

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