Transplant in the Elderly Population

Author(s):

Miguel-Angel Perales, MD,Nelli Bejanyan, MD

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.

EP: 1.Role of Allogeneic Transplants in Hematologic Malignancies

EP: 2.Hematologic Malignancies and Transplant Options and Conditioning Regimens Used in Allo-HSCT

EP: 3.Supportive Care Measures for Patients Planning to Receive an Allogenic Transplant

EP: 4.Transplant Complications and Survival Outcomes

EP: 5.Clinical Trial Update: CTN Trial

EP: 6.Graft-versus-Host Disease Prophylaxis and Management

EP: 7.Patient Case Studies of GvHD

EP: 8.Emerging Cellular Therapies in Hematologic Malignancies

Now Viewing

EP: 9.Transplant in the Elderly Population

EP: 10.Toxicity Assessment of Precision-Engineered Allo-HSCT

EP: 11.The Role of Allo-HSCT in Higher-Risk MDS

EP: 12.Investigational Allo-HSCT for Advanced Hematologic Malignancies

EP: 13.The Future of Allo-HSCT and Cellular Therapies

EP: 14.OncLive Peer Exchange on Allo-HSCT: Conclusion of Discussion

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.