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Is Bone Marrow Transplantation Appropriate in Older Patients?

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Current Controversies in Bone Marrow Transplantation

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Many, if not most, protocols involving allogeneic bone marrow transplant (allo-BMT) have eligibility criteria that include parameters of patient age. Generally, eligibility includes patients less than 55, 60, or 65 yr of age. Many autologous BMT (ABMT) protocols also have age cutoffs restricting patient eligibility. The reason for such an age cutoff is presumably that the transplant procedure itself is prohibitively risky in older patients. Common transplant teachings suggest that the older the patient, the higher the risk of graft-vs-host disease (GVHD), treatment-related mortality (TRM), overall toxicity, and decreased disease-free survival (DFS). However, much of this dogma is based on literature comparing pediatric patients to adult patients. Indeed, few series actually examine the potential toxicity of transplantation comparing older adults to younger adults. Additionally, in the field of autologous transplantation (autotransplantation), the use of primed peripheral blood progenitor cells (PBPCs) has drastically reduced the treatment-related toxicities, at least in part, because of enhanced engraftment rates; therefore, some of the older literature concerning autotransplantation in older adults is dated.

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Authors
  1. Brian J. Bolwell MD
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Editors and Affiliations

  1. Bone Marrow Transplant Program, Department of Hematology/Medical Oncology, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Brian J. Bolwell MD (Director, Staff Physician) (Director, Staff Physician)

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© 2000 Humana Press Inc., Totowa, NJ

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Bolwell, B.J. (2000). Is Bone Marrow Transplantation Appropriate in Older Patients?. In: Bolwell, B.J. (eds) Current Controversies in Bone Marrow Transplantation. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-657-7_2

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  • DOI: https://doi.org/10.1007/978-1-59259-657-7_2

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9812-7

  • Online ISBN: 978-1-59259-657-7

  • eBook Packages: Springer Book Archive

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