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Patients in their 50 and 60s are good candidates for stem cell transplants after all, new studies show.

Conventional wisdom has been that people in their 50s and 60s are not good candidates for stem cell transplantation (SCT) but several new studies show age should no longer be a barrier.

Research presented at the 2007 BMT Tandem Meetings of the American Society of Blood and Bone Marrow Transplantation (ASBMT) and the Center for International Blood and Marrow Transplant Research (CIBMTR) in Keystone, CO, revealed that SCT can be just as successful in the elderly as it is in young people.

The findings presented at the meetings showed that:

*Elderly peopleeven those in their eighth decadecan be successfully treated with high-dose chemotherapy followed by SCT.

*Studies of elderly patients with the blood cancers multiple myeloma and malignant lymphoma revealed age did not affect outcome in otherwise healthy patients.

*Conventional long-term lower dose chemotherapy treatments for older patients may be more toxic and actually more expensive over the long run than a single transplant.

"If your doctor tells you you're not a good candidate for transplant because of your age, chances are it's just not true," said Roy Beveridge, MD, director of the transplant program at Inova Fairfax Hospital in Falls Church, VA.

Studies of SCT in multiple myeloma patients ages 70-79 and patients age 60 and above with malignant lymphoma who received autologous transplants found they did as well as their younger counterparts.

"Most of the multiple myeloma (ML) patients age 70 or older are offered less effective non-transplant treatments that in the long run may be more toxic and expensive than a single autologous transplant. Elderly patients are also excluded from clinical trials so there's little data available on how they respond to transplant," said Muzaffar Qazilbash, MD, associate professor in the department of stem cell transplantation MD Anderson Cancer Center in Houston, TX.

In a study of 26 patients, ages 70 to79, treated with SCT over the past five years, Qazilbash found that "the combination of high-dose chemotherapy and transplant is safe and feasible in selected patients in this age group." The study also found older patients had a longer overall survival when the transplant was used early in the disease course, compared to those who received the transplant later, after their disease had become resistant to chemotherapy.

"At 100 days post-transplant, there were zero deathsan excellent result in this population," Qazilbash concluded. Twenty-two of 26 patients were alive after a median follow-up of 25 months, and the duration of survival and disease remission were comparable to those seen in younger patients.

A related study headed by Beveridge found that in patients with ML with comparable pre-transplant health status there were no statistical differences between younger and older patients. Patients in the study were given induction chemotherapy followed by autologous transplant.

"Our data suggest that older ML patients who are otherwise generally healthy can be treated with autologous stem cell treatment strategies comparable to those developed for younger people," he added.

For more information on the BMT Tandem Meetings go to: www.asbmt.org/annualmeet or the online newsroom at www.bmtnewsroom.org
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Publication:Transplant News
Date:Apr 1, 2007
Words:506
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