Opinion
Video
Transplant in the Elderly Population
Author(s):
This session will focus on considerations and outcomes of allo-HSCT specifically among patients over 55 years of age. The panel will discuss how transplant protocols and supportive care measures can be optimized for this population who are at higher risk of comorbidities, toxicity and poor functional status.
This is a video synopsis/summary of a Peer Exchange featuring Miguel-Angel Perales, MD; Nelli Bejanyan, MD; Amandeep Salhotra, MD; and Arpita Gandhi, MD, MS.
The panel discusses the challenges of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in older patients, particularly in balancing the risk-benefit ratio of regimen intensity, relapse, and toxicity. The Orca-T trial, which uses a graft manipulation strategy involving the addition of regulatory T cells and conventional T cells to a CD34-selected graft, reported promising outcomes for patients older than 55 years at the 2023 American Society of Hematology Annual Meeting & Expo.
Although the cohort of older patients was small (25 patients), with most being between the ages of 55 and 65, they experienced a 0% transplant-related mortality rate. The graft manipulation strategy allowed for the use of single-agent tacrolimus to control graft-vs-host disease successfully.
Older patients in the Orca-T trial achieved a 75% GVHD-free, relapse-free survival rate, with an overall survival exceeding 90% (96% for the older group and 100% for younger patients) and a disease-free survival close to 90%. While more data focusing on older patients is needed, these results are promising, and future studies should compare this approach to the current standard of post-transplant cyclophosphamide.
Video synopsis is AI-generated and reviewed by OncLive® editorial staff.
