Allogeneic BMT in patients above 45 years of age: a single center experience

Increasing age has been reported to be associated with worse outcome and hi gher occurrence of complication after allogeneic bone marrow transplantatio n. We analysed a cohort of 39 patients between the ages of 45 and 57 (media n 49 years) with different hematologic malignancies who had undergone BMT i n our institution over the preceeding 4 years. Pretransplant conditioning c onsisted of Bu/CY2, GVHD prophylaxis of a combination of cyclosporine and ' short' methotrexate. At present 54% of patients remain alive (with a median follow-up 44 months), the probability of survival at 5 years is 53% (5-yea r DFS 78%). The 5-year survival probability in the control group of younger patients is 53% (P = 0.8003), Main causes of death were GVHD (4 patients, 10%), relapse (5 patients, 13%) and infection (6 patients, 15%), The incide nce of acute GVHD grade II-IV was 51% (grade III-IV 0% patients), the incid ence of chronic GVHD 49% (limited 18% and extensive 31% patients). Our resu lts suggest that allogeneic BMT can be performed in patients above the age of 45 gears with acceptable morbidity and mortality, especially if a family HLA matched donor is available.