Allogeneic Hematopoietic Cell Transplantation in Elderly Patients in a Latin American Country: Analysis of 11 Years of Data from the Brazilian Registry SBTMO/CIBMTR

• Published in: Transplantation and cellular therapy 2024-12
• Main Authors: Duarte, Fernando Barroso, Garcia, Yhasmine Delles Oliveira, Hamerschlak, Nelson, Funke, Vaneuza Araújo Moreira, Moreira, Maria Claudia Rodrigues, Paz, Alessandra Aparecida, Filho, Jayr Schmidt, Astigarraga, Claudia Caceres, da Silva, Roberto Luiz, de Molla, Vinícius Campos, Silvério, Alexandre, Rocha, Vanderson Geraldo, Feliciano, João Victor Piccolo, Barros, George Maurício Navarro, Colturato, Vergílio Antônio Rensi, Nabhan, Samir Kanaan, Farias, João Samuel de Holanda, Maia, Ana Carolina Arrais, Atalla, Ângelo, Chiattone, Ricardo, Macedo, Maria Cristina Martins de Almeida, Aranha, Milton Alexandre Ferreira, Zogbi, Yana Augusta Novis, Lener, Décio, Soares, Rodolfo Daniel de Almeida, Scheinberg, Phillip, Calixto, Rodolfo Froes, Teixeira, Gustavo Machado, Colella, Marcos Paulo, Rodrigues, Celso Arrais, Simione, Anderson João, da Silva, Cinthya Corrêa, Martin, Paul J, Flowers, Mary E
• Format: Article
• Language: English
• Subjects: allogeneic hematopoietic cell transplantation; elderly; myeloproliferative diseases
• ISSN: 2666-6367; 2666-6367
• DOI: 10.1016/j.jtct.2024.12.003

•Allogeneic HCT for patients aged 60 years and older has increased overtime.•The use of HLA-haploidentical donors in elderly patients has increased since 2018.•Lower OS in the elderly using related haploidentical and mismatched unrelated donors.•Increased mortality risk in the elderly using haploidentical and cord blood donors•Mortality was lower for HCT during the 2015-2020 than for 2012-2014 period. This study analyzed recent changes in the utilization of allogeneic HCT for treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative diseases (MPD) and the survival of HCT recipients ≥60 years of age in Brazil. This retrospective registry study included patients who received a first allogeneic HCT from any donor between 2012 and 2023. Of the 6657 patients, 444 (7%) were 60 years of age or older who received grafts from HLA-matched related (42%) or unrelated (20%) donors or HLA-haploidentical donors (32%). The proportion of HCT recipients 60 years of age or older increased gradually from 3.2% in 2012 to 16% in 2023 mostly due to the increased use of HLA-haploidentical donors since 2018. Overall survival (OS) at day 100 was 77%, and estimated OS at 12 months was 53% (95% CI, 48-58). OS at 12-months was higher for transplants during 2015-2017 (58%) and 2018-2020 (68%) compared to 2012-2014 (45%), but it did not differ for those during 2021-2023 (49%). Mortality with HLA-haploidentical donors (HR 2.35; 95%CI; 1.65-3.34 [p