Unrelated donor transplantation over the age of 55. Are we merely getting (b)older?
Bone Marrow Transplantation
In summary, unrelated donor transplantation can benefit some older patients with advanced hematologic malignancies and age should no longer represent an absolute contra-indication for transplantation. Nevertheless, there is a substantial risk for failure due to toxicity, graft-versus-host disease or relapse. Hence, there is an urgent need for improved treatment strategies and continued enrollment to prospective studies. The optimal conditioning remains elusive, but should provide survival as well as quality of life benefits. The term 'reduced intensity transplantation' encompasses a variety of regimens, of differing intensity, spectrum of activity, and toxicity, which require further study. Several recent studies indicate the ability to administer intensive chemotherapy with encouraging success rates. Graft-versus-host disease prophylaxis vs therapeutic induction of graft-versus-host disease represents another unresolved dilemma to be addressed in future studies. © 2005 Nature Publishing Group All rights Reserved.
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