Elderly Patients with Myelodysplastic Syndromes can Have Successful Transplants

By Rachel Whetstone from In The Cloud Copy

Many patients with myelodysplastic syndromes (MDS) are elderly when they’re diagnosed with the disease. Although stem cell transplants are often thought to be riskier for patients that are over the age of 65, a new study shows there is no significant difference in transplant success and 3-year survival rates based on age. Older patients have often been denied treatment in favor of younger people, but this new study could mean more chances for patients who are 70 years or older.

Diseases of the Blood Cells

Myelodysplastic syndromes (MDS) are a group of disorders that affect the cells in the bone marrow. For people with MDS, blood cells that are forming in the bone marrow never mature or become healthy blood cells. There are no symptoms in the early stages, but as the disease progresses, patients start to feel shortness of breath and fatigue. They bleed more easily and contract frequent infections. Some types of the disease can develop into acute myeloid leukemia.

People who have previously had chemotherapy or radiation therapy have an increased risk of developing MDS. Exposure to tobacco smoke, pesticides, or other toxic chemicals can also increase the risk for the disease. Some subtypes of the disease, however, have no known cause.

HCT Transplants Can Help

MDS can often cause complications and lead to a shortened lifespan. One of the best chances for patients to fully recover is to receive allogeneic hematopoietic stem cell transplantation (HCT). This replaces the damaged cells in the bone marrow with healthy cells. The procedure itself can have complications, so it is usually reserved for people with life-threatening diseases.

Many MDS patients fall into this category, but doctors and insurance companies have been hesitant to recommend the treatment to patients over 70 years of age.

Most MDS Patients are Older

Approximately 15,000 patients are diagnosed with MDS every year in the United States. In that group of patients, 80% are older than 65.

Previous research supported the idea that age did not affect the success of HCT, but insurance companies were reluctant to accept the research. The US Centers for Medicare & Medicaid Services had concluded in 2010 that the research for using the treatment in older patients was insufficient.

Hopeful Outlooks for Older Patients

The Center for International Bone Marrow Transplant Research compared outcomes in groups of patients aged 55 to 64 years with patients who were 65 or older. 592 of the patients were ages 55- 64 years, while 688 of the patients were at least 65 years. The study balanced the groups for other characteristics that could affect the outcomes.

Rates of nonrelapse mortality as well as the 3-year overall survival were compared between the two groups. Researchers found the rates to be similar in both groups who had received HCT transplants.

The overall survival rate after 3 years was 42% in the younger group. The older group had a rate of 37%.

The nonrelapse mortality was 25% in the younger patient group, compared to 28% in the older group.

While there is a slightly better outcome for the younger patients, the difference between the two groups was not as large as was previously suspected. With this new information, older patients with MDS have new hope of getting treatments approved.

Check out the original study here.

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