Outcome of T cell-depleted transplantation after conditioning with an intensified regimen in patients aged 50 years or more is comparable with that in younger patients

One hundred and thirty-one patients were transplanted for AML-CR1, ALL-CR1 or CML-CP1 after conditioning with 120 mg/kg body weight cyclophosphamide a nd 2 x 4.5 Gy TBI, Conditioning was intensified with the addition of 42 mg/ m(2) idarubicin. Grafts were T cell-depleted using counterflow centrifugati on, Donors were HLA-identical siblings, We compared outcome of BMT in 109 p atients aged. less than 50 (median, 35) years with that of 22 patients with an age of 50 years or more (median, 53 years). For the patients aged <50 y ears, 2-year probabilities of treatment-related mortality, relapse, surviva l and leukemia-free survival were 26% (95% CI, 17% to 35%), 26% (95% CI, 17 % to 35%), 64% (95% CI, 55% to 73%), and 56% (95% CI, 47% to 65%). For the patients aged greater than or equal to 50 years, these figures were 13% (95 % CI, 0% to 30%), 24% (95% CI, 6% to 42%), 66% (95% CI, 46% to 86%), and 67 % (95% CI, 47% to 87%), respectively. Outcome did not differ significantly between the two age groups. TRM was within the range of that reported in th e literature for recipients of T cell-depleted grafts. We conclude that T c ell-depleted transplantation after a conditioning regimen that was intensif ied with the addition of idarubicin is feasible in patients aged greater th an or equal to 50 years. For this age group of patients, results of nonmyel oablative regimens should be compared with that obtained with T cell-deplet ed grafts.