Curative Efficacy Analysis Of Elderly Patients With Hematological Malignancy After Allogeneic Hematopoietic Stem Cell Transplantation

Objective To investigate the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for elderly patients with hematologic malignancy and to analysis risk factors of survival.Methods A total of26patients with hematologic malignancy, aged older than50years old and who received allo-HSCT, were included in this study. Overall survival (OS), disease-free survival (DFS), graft-versus-host disease (GVHD), transplant-related mortality (TRM), and risk factors of survival were investigated. The statistics was performed by software SPSS17.0and R2.15.0.Results The median age of the26patients was52.5(50-58), including15males and11females. In all,17patients had complications before transplant,23patients received HLA matched sibling donor transplant and3received alternative donor transplant. The sources of stem cells were bone marrow for2patients and peripheral blood for24patients. Of the26patients, engraftment failure was observed only in1patient (3.8%). The median time for nuetrophil and pletlet engraftment were16(12-26) days and22(10-47) days, respectively. The probability of aGVHD and grade Ⅱ-Ⅳ aGVHD100days post transplant were61.5±1.0%and15.6±0.5%, respectively. The probability of cGVHD and extensive cGVHD2years post transplant were45.9±1.1%and25.6±0.9%, respectively. The5-year OS rate was61.8±10.1%. Risk fators of OS were male patients, more than1year from diagnosis to transplant, FK506as GVHD prophylaxis, CD34+cells less than2.0×106/kg and occurred grade Ⅱ-Ⅳ aGVHD. The5-year DFS rate was51.5±12.6%. Risk fators of DFS were male patients, CD34+cells less than2.0×106/kg and occurred grade Ⅱ-Ⅳ aGVHD.Conclusions Allo-HSCT is an effective treatment for eldlery patients with hematologic malignancy. Females, less than1year form diagnosis to transplant, CsA as GVHD prophylaxis, CD34+cells more than2.0×106/kg and grade0-1aGVHD would be beneficial for higher survival. Improving the prevention and therapy of GVHD is a key factor for enhancing allo-HSCT curative effect in elderly patients with hematologic malignancies.