Allogeneic Hematopoietic Cell Transplantation in Elderly Patients in a Latin American Country: Analysis of 11 Year of Data from the Brazilian Registry SBTMO/CIBMTR
•Allogeneic hematopoietic cell transplantation (HCT) for patients aged 60 years and older has increased over time.•The use of human leukocyte antigen (HLA)-haploidentical donors in elderly patients has increased since 2018.•There is lower overall survival in the elderly using related haploidentical...
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| creator | 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. |
| description | •Allogeneic hematopoietic cell transplantation (HCT) for patients aged 60 years and older has increased over time.•The use of human leukocyte antigen (HLA)-haploidentical donors in elderly patients has increased since 2018.•There is lower overall survival in the elderly using related haploidentical and mismatched unrelated donors.•There is increased mortality risk in the elderly using haploidentical and cord blood donors.•Mortality was lower for HCTs during the 2015-2020 period than for the 2012-2014 period.
This study analyzed recent changes in the utilization of allogeneic hematopoietic cell transplantation (HCT) for treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative diseases (MPDs) 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 human leukocyte antigen (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 to 2017 (58%) and 2018 to 2020 (68%) compared with 2012 to 2014 (45%), but it did not differ for those during 2021 to 2023 (49%). Mortality with HLA-haploidentical donors (HR, 2.35; 95% CI, 1.65-3.34 [P < .001]) and cord blood donors (HR, 4.68; 95%,CI, 1.29-16.9 [P = .01]) was higher than with HLA-matched related donors. Mortality was lower for patients with transplants during the 2015 to 2020 period (HR, 0.57; 95% CI, .34-.96 [.037]) than for those during 2012 to 2014.This study revealed a gradual increase in the use of allogeneic HCT in individuals aged 60 years and older in Brazil. While use of haploidentical donors has increased worldwide, its association with increased mortality in the elderly population warrants caution when considering this treatment |
| doi_str_mv | 10.1016/j.jtct.2024.12.003 |
| format | Article |
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This study analyzed recent changes in the utilization of allogeneic hematopoietic cell transplantation (HCT) for treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative diseases (MPDs) 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 human leukocyte antigen (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 to 2017 (58%) and 2018 to 2020 (68%) compared with 2012 to 2014 (45%), but it did not differ for those during 2021 to 2023 (49%). Mortality with HLA-haploidentical donors (HR, 2.35; 95% CI, 1.65-3.34 [P < .001]) and cord blood donors (HR, 4.68; 95%,CI, 1.29-16.9 [P = .01]) was higher than with HLA-matched related donors. Mortality was lower for patients with transplants during the 2015 to 2020 period (HR, 0.57; 95% CI, .34-.96 [.037]) than for those during 2012 to 2014.This study revealed a gradual increase in the use of allogeneic HCT in individuals aged 60 years and older in Brazil. While use of haploidentical donors has increased worldwide, its association with increased mortality in the elderly population warrants caution when considering this treatment</description><identifier>ISSN: 2666-6367</identifier><identifier>EISSN: 2666-6367</identifier><identifier>DOI: 10.1016/j.jtct.2024.12.003</identifier><identifier>PMID: 39674548</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Allogeneic hematopoietic cell transplantation ; Elderly ; Myeloproliferative diseases</subject><ispartof>Transplantation and cellular therapy, 2024-12</ispartof><rights>2024 The American Society for Transplantation and Cellular Therapy</rights><rights>Copyright © 2024 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. 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This study analyzed recent changes in the utilization of allogeneic hematopoietic cell transplantation (HCT) for treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative diseases (MPDs) 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 human leukocyte antigen (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 to 2017 (58%) and 2018 to 2020 (68%) compared with 2012 to 2014 (45%), but it did not differ for those during 2021 to 2023 (49%). Mortality with HLA-haploidentical donors (HR, 2.35; 95% CI, 1.65-3.34 [P < .001]) and cord blood donors (HR, 4.68; 95%,CI, 1.29-16.9 [P = .01]) was higher than with HLA-matched related donors. Mortality was lower for patients with transplants during the 2015 to 2020 period (HR, 0.57; 95% CI, .34-.96 [.037]) than for those during 2012 to 2014.This study revealed a gradual increase in the use of allogeneic HCT in individuals aged 60 years and older in Brazil. 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Caceres</au><au>da Silva, Roberto Luiz</au><au>de Molla, Vinícius Campos</au><au>Silvério, Alexandre</au><au>Rocha, Vanderson Geraldo</au><au>Feliciano, João Victor Piccolo</au><au>Barros, George Maurício Navarro</au><au>Colturato, Vergílio Antônio Rensi</au><au>Nabhan, Samir Kanaan</au><au>Farias, João Samuel de Holanda</au><au>Maia, Ana Carolina Arrais</au><au>Atalla, Ângelo</au><au>Chiattone, Ricardo</au><au>Macedo, Maria Cristina Martins de Almeida</au><au>Aranha, Milton Alexandre Ferreira</au><au>Zogbi, Yana Augusta Novis</au><au>Lener, Décio</au><au>Soares, Rodolfo Daniel de Almeida</au><au>Scheinberg, Phillip</au><au>Calixto, Rodolfo Froes</au><au>Teixeira, Gustavo Machado</au><au>Colella, Marcos Paulo</au><au>Rodrigues, Celso Arrais</au><au>Simione, Anderson João</au><au>da Silva, Cinthya Corrêa</au><au>Martin, Paul J.</au><au>Flowers, Mary E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Allogeneic Hematopoietic Cell Transplantation in Elderly Patients in a Latin American Country: Analysis of 11 Year of Data from the Brazilian Registry SBTMO/CIBMTR</atitle><jtitle>Transplantation and cellular therapy</jtitle><addtitle>Transplant Cell Ther</addtitle><date>2024-12-12</date><risdate>2024</risdate><issn>2666-6367</issn><eissn>2666-6367</eissn><abstract>•Allogeneic hematopoietic cell transplantation (HCT) for patients aged 60 years and older has increased over time.•The use of human leukocyte antigen (HLA)-haploidentical donors in elderly patients has increased since 2018.•There is lower overall survival in the elderly using related haploidentical and mismatched unrelated donors.•There is increased mortality risk in the elderly using haploidentical and cord blood donors.•Mortality was lower for HCTs during the 2015-2020 period than for the 2012-2014 period.
This study analyzed recent changes in the utilization of allogeneic hematopoietic cell transplantation (HCT) for treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative diseases (MPDs) 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 human leukocyte antigen (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 to 2017 (58%) and 2018 to 2020 (68%) compared with 2012 to 2014 (45%), but it did not differ for those during 2021 to 2023 (49%). Mortality with HLA-haploidentical donors (HR, 2.35; 95% CI, 1.65-3.34 [P < .001]) and cord blood donors (HR, 4.68; 95%,CI, 1.29-16.9 [P = .01]) was higher than with HLA-matched related donors. Mortality was lower for patients with transplants during the 2015 to 2020 period (HR, 0.57; 95% CI, .34-.96 [.037]) than for those during 2012 to 2014.This study revealed a gradual increase in the use of allogeneic HCT in individuals aged 60 years and older in Brazil. While use of haploidentical donors has increased worldwide, its association with increased mortality in the elderly population warrants caution when considering this treatment</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39674548</pmid><doi>10.1016/j.jtct.2024.12.003</doi><orcidid>https://orcid.org/0009-0003-5625-005X</orcidid><orcidid>https://orcid.org/0009-0006-9718-5786</orcidid><orcidid>https://orcid.org/0000-0002-4292-6472</orcidid><orcidid>https://orcid.org/0000-0001-9051-1215</orcidid><orcidid>https://orcid.org/0000-0003-1631-0911</orcidid><orcidid>https://orcid.org/0000-0002-9506-6867</orcidid><orcidid>https://orcid.org/0000-0001-5531-964X</orcidid><orcidid>https://orcid.org/0000-0002-8593-2493</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2666-6367 |
| ispartof | Transplantation and cellular therapy, 2024-12 |
| issn | 2666-6367 2666-6367 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3146777570 |
| source | Alma/SFX Local Collection |
| subjects | Allogeneic hematopoietic cell transplantation Elderly Myeloproliferative diseases |
| title | Allogeneic Hematopoietic Cell Transplantation in Elderly Patients in a Latin American Country: Analysis of 11 Year of Data from the Brazilian Registry SBTMO/CIBMTR |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T17%3A32%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Allogeneic%20Hematopoietic%20Cell%20Transplantation%20in%20Elderly%20Patients%20in%20a%20Latin%20American%20Country:%20Analysis%20of%2011%20Year%20of%20Data%20from%20the%20Brazilian%20Registry%20SBTMO/CIBMTR&rft.jtitle=Transplantation%20and%20cellular%20therapy&rft.au=Duarte,%20Fernando%20Barroso&rft.date=2024-12-12&rft.issn=2666-6367&rft.eissn=2666-6367&rft_id=info:doi/10.1016/j.jtct.2024.12.003&rft_dat=%3Cproquest_cross%3E3146777570%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3146777570&rft_id=info:pmid/39674548&rft_els_id=S2666636724008042&rfr_iscdi=true |