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What the internist should know about stem cell transplant in the elderly patient

  • Michael Medinger
    Affiliations
    Division of Hematology, Department of Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland

    Division of Internal Medicine, Department of Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
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  • Jakob Passweg
    Correspondence
    Corresponding author: Division of Hematology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
    Affiliations
    Division of Hematology, Department of Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
    Search for articles by this author

      Abstract

      Most hematological malignancies are increasing in frequency with age. Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapeutic option for patients with malignant and non-malignant hematological diseases. The treatment of elderly patients with advanced hematological malignancies has expanded to include reduced intensity conditioning allo-HCT. Physicians increasingly refer older patients for allo-HCT due to more experience and improved supportive care in allo-HCT. This review article discusses the available data regarding the feasibility, tolerability, toxicity, and effectiveness of allo-HCT in different hematological diseases in the elderly. Over the past decade, utilization and survival after allo-HCT have increased in patients ≥70 years. Selected adults ≥70 years with hematological diseases should be evaluated for transplantation.

      Keywords

      Abbreviations:

      BMI (Body mass index), CCI (Charlson Comorbidity Index), CIRS-G (Cumulative Illness Rating Scale–Geriatrics), KF (Kaplan-Feinstein Scale), HCT-CI (Hematopoietic Cell Transplantation Comorbidity Index), PS (Performance Status), ADL (Katz Activities of Daily Living), IADL (Lawton Instrumental Activities of Daily Living), SF-36 PCS (Physical Component Summary of the SF-36), FI (Fried Frailty Index), SF-36 MCS (Mental component summary of the SF-36)
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