Stem Cell Transplants Over the Ages

Blood cancers in people up to 75 years old can be successfully treated with stem cell transplants

(RxWiki News) Stem cell transplants that replace damaged blood cells with healthy ones can be life-saving procedures for people living with blood cancers. Advances have made stem cell transplants available to more people.

Stem cell transplants, which can use the patient’s own cells (autologous) or those of a donor (allogenic), can sometimes cure blood (hemotologic) cancers and other blood disorders.

New research has demonstrated that people up to the age of 75 can undergo successful transplants, and different types of cells can be used when perfectly matched or relative donor cells aren’t available.

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Jeffrey Miller, MD, deputy director of the Masonic Cancer Center and the Clinical and Translational Sciences Institute at the University of Minnesota in Minneapolis, summarized the progress that’s been made recently.

"Whereas transplant would not have been an option for many patients without a sibling or other perfectly matched donor even several years ago, exciting new strategies have afforded them the opportunity to gain significant benefit from this procedure today.”

Today, what’s called haploidentical (half-matched) and cord blood cells (stem cells gathered from a baby’s umbilical cord) can be used in stem cell transplants to treat people of all ages with blood cancers and diseases.

The stem cells are gathered from either the bone marrow or the blood.

A recent study, led by Yvette Kasamon, MD, of the Johns Hopkins Kimmel Cancer Center in Baltimore, evaluated the effectiveness of using alternative donor cells in individuals between the ages of 50 and 75.

This study looked at non-myeloablative, related haploidentical bone marrow or blood stem cell transplants (haploBMT).

Non-myeloablative transplant — sometimes called “mini-transplant” or “reduced intensity transplant” — is a method that uses chemotherapy or radiation to prepare the patient to receive the healthy donor cells. The process suppresses the immune system just enough so the new transplanted cells can grow.

The cells used for the transplants in this study came from relatives who were only half-matched.

Dr. Kasmon and colleagues evaluated the effectiveness of this procedure in 273 older patients.

These researchers found very little difference in the results among patients in their 50s, 60s and 70s. Progression-free survival (the time during which the disease doesn’t worsen) was similar — between 36 and 39 percent. Two-year probability of overall survival was also similar — ranging from 44 percent among patients in their 70s to 51 percent in patients in their 50s and 56 percent for patients in their 60s.

Dr. Kasamon said in a statement, “These results underscore that a reduced-intensity, related haploidentical transplant should be considered a very reasonable treatment option for suitable patients up to at least age 75 who require a transplant."

This study was presented at the American Society of Hematology (ASH) Annual Meeting and Exposition in New Orleans. It should be noted that all research is considered preliminary before being published in a peer-reviewed journal.

No conflicts of interest were disclosed.

Review Date: 
December 6, 2013