Table 3.
Characteristics of patients aged ≥60 years undergoing allogeneic transplantation during the pre-TOP and TOP MDC eras
| Variable | Pre-TOP (2005-2012) | TOP (2013-2018) | P |
|---|---|---|---|
| Received cellular therapy, n | 74 | 85 | — |
| After initial deferral, n (%) | NA | 13 (15) | |
| After declined, n (%) | NA | 0 (0) | |
| Age, median (range), y | 64 (60-73) | 67 (60-75) | <.001 |
| Age ≥70 y, n (%) | 4 (5.4) | 16 (18.9) | .015 |
| Diagnosis, n (%) | .69 | ||
| ALL | 3 (4) | 5 (5.9) | |
| AML | 33 (44.6) | 41 (48.2) | |
| MDS | 14 (18.9) | 21 (24.7) | |
| MPN | 6 (8.1) | 5 (5.9) | |
| NHL | 11 (14.9) | 7 (8.2) | |
| Other | 7 (9.5) | 6 (7.1) | |
| Disease risk classification, n* | 62 | 54 | .46 |
| Low, n (%) | 21 (33.9) | 23 (42.6) | |
| Intermediate, n (%) | 12 (19.4) | 6 (11.1) | |
| High, n (%) | 29 (46.8) | 25 (46.3) | |
| HCT–comorbidity index score, n | 61 | 85 | |
| Median (range) | 2 (0-9) | 1 (0-8) | .077 |
| Score ≥3, n (%) | 30 (49.2) | 32 (37.6) | .18 |
| IADL score, n | 61 | 78 | |
| Median (range) | 14 (3-14) | 14 (4-14) | .014 |
| IADL <14, n (%) | 30 (49.2) | 23 (29.5) | .022 |
| 4-m walk test, n | 41 | 85 | |
| Frail†, n (%) | 13 (31.7) | 5 (5.9) | <.001 |
| Donor sources, n (%) | .11 | ||
| Matched related | 28 (37.3) | 31 (36.4) | |
| Matched unrelated | 30 (40) | 44 (51.8) | |
| Haploidentical + cord blood | 12 (16) | 10 (11.8) | |
| Single mismatched unrelated, n (%) | 4 (5.3) | 0 (0) | |
| Conditioning intensity, n (%) | 1.0 | ||
| Myeloablative regimen | 13 (17.6) | 15 (17.6) | |
| Reduced Intensity regimen | 61 (82.4) | 70 (82.4) | |
| Myeloablative regimens, n | 13 | 15 | |
| Flu/Bu/alemtuzumab or, n (%) | 11 (84.6) | 15 (100) | |
| ATG TBI/etoposide, n (%) | 2 (15.4) | 0 (0) | |
| Reduced intensity regimens, n | 61 | 70 | |
| Clo/Mel/alemtuzumab, n (%) | 16 (26.2) | 0 (0) | |
| Flu/Mel/alemtuzumab, n (%) | 30 (49.2) | 58 (82.9) | |
| Flu/Mel/ATG, n (%) | 13 (21.3) | 12 (17.1)‡ | |
| Flu/Mel, n (%) | 1 (1.65) | 0 (0) | |
| Flu/Bu/rituximab, n (%) | 1 (1.65) | 0 (0) |
ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; ATG, antithymocyte globulin; Bu, busulfan; Clo, clofarabine; Flu, fludarabine; MDS, myelodysplastic syndrome; Mel, melphalan; MPN, myeloproliferative neoplasm; NA, not applicable; NHL, non-Hodgkin lymphoma.
Risk according to American Society for Blood and Marrow Transplantation disease classification.
Frail 4-meter walk time defined for male patients as ≤0.65 m/s if ≤173 cm and ≤0.76 m/s if >173 cm. For female patients, frailty was defined as ≤0.65 m/s if ≤159 cm and ≤0.76 m/s if >159 cm.
Three patients also received low-dose total body irradiation (TBI) 200-400 cGy.