ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR ACUTE-LEUKEMIA IN PATIENTSOVER THE AGE OF 40 YEARS

Extension of allogeneic transplants to older patients has been limited by a high risk of transplant-related death and graft-versus-host dise ase. To evaluate the feasibility in older patients, a retrospective an alysis of the procedure was performed for first remission acute leukem ia in 192 patients aged over 40 years and compared with a group of 111 9 recipients aged from 16 to 40 years reported to the EBMT from 1986 t o 1992. Patient-, disease-, and treatment-related variables were compa red between the two age groups using the chi(2) statistical method for categorical variables. Variables differing significantly or recognize d as potential prognostic factors were included in a multivariate anal ysis. Leukemia-free survival and relapse were comparable among the age groups in the two types of leukemias. Incidence of graft-versus-host disease was higher in the older group of ALL patients. Older patients with AML in first remission had a higher treatment-related mortality i ncidence, with no influence on survival. A pair-matched analysis of AM L patients did not show any statistical difference in the probability of LFS, RI, TRM, and survival for the two age cohorts of patients. The se results suggest that BMT should be considered for patients over 40 years of age.