Does age matter when considering hematopoietic stem cell transplant for patients with MDS?

FAQ Library published on October 13, 2016
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David P. Steensma, MD, FACP
Associate Professor of Medicine
Harvard Medical School
Senior Physician
Dana-Farber Cancer Institute
Boston, Massachusetts
Does age matter when considering hematopoietic stem cell transplant for patients with MDS?

Welcome to Managing Myelodysplastic Syndromes. My name is David Steensma, and I am an Associate Professor of Medicine at Harvard Medical School in Boston and also a clinical faculty member in the Adult Leukemia Group at the Dana-Farber Cancer Institute. One question I am frequently asked about patients with MDS is, “Does age matter when considering hematopoietic stem cell transplant?” The answer is, certainly age does matter, but the age range at which transplants are done is expanding. Our center now does them routinely for patients who are in their early 70s, and we have even done transplants for patients as old as 75 or 76 years using a reduced-intensity conditioning approach. That reduced-intensity conditioning is very important for patients who are over the age of 55-60 years old. Below 55, most patients can tolerate an intensive conditioning pre‑transplant regimen. The thing that matters perhaps just as much as the chronological age of the patient is their biological age. By that I mean, what are their comorbid conditions and their performance status? Because we all know 70-year-olds who are robust and continue to be very active who have no major comorbid conditions, and we know 60-year-olds who have very serious comorbid conditions who would never be a candidate for something as intense as stem cell transplant. It has to be considered on a case-by-case basis. I am often asked by physicians whether 60 or 62 years old is too old, and it is very difficult to say without actually seeing the patient and evaluating them, but we certainly will do transplant consultations up to age 75. Thank you for viewing this activity, and for additional resources, please view the other educational activities on ManagingMDS.com.

Last modified: September 30, 2016
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