Impact of age on hospitalization and outcomes post allogeneic hematopoietic cell transplantation outcome, a single center experience.

Abstract

The outcomes of allogeneic hematopoietic cell transplantation (HCT) in older patients are not well defined. We retrospectively analyzed the outcomes of 332 patients, with the median age of 65years (range, 60-76), between 2014 and 2019. We categorized them to 3 age groups (G): G1, 60-65years (n = 175); G2, > 65-70years (n = 127); and G3, > 70years (n = 30). The median length of hospitalization during the initial HCT period was 30days, with a significant difference when stratified by age (p = 0.049). Overall, 183 (58.7%) patients were re-hospitalized within the first 6months post HCT, and 60 (21.6%) in the second 6-month period. The 2-year OS was 56% in G1, 53% in G2, and 34% in G3 (p = 0.05). The 2-year event-free survival (EFS) was 54% for G1, 49% for G2, and 31% for G3 (p = 0.04). Non-relapse mortality (NRM) at 2years was 25% in G1, 36% in G2, and 52% in G3 (p = 0.008). In multivariable analysis, patients aged 60-65years had significantly better EFS (p = 0.04) and had a trend toward lower NRM (p = 0.05) than those aged > 70years. Re-admission in the first 6months post HCT had a significant impact on OS, EFS, and NRM. HCT-specific comorbidity index > 3 had significantly affected NRM. Finally, age had a significant influence on length of hospitalization during HCT. In conclusion, patients aged > 70years have an inferior EFS and higher NRM. This likely related to higher rate of re-admissions due to infectious complications (84%).