I'm Dr. Mohammed Umair Mushtaq. I'm Associate Professor of Medicine at University of Kansas Medical Center. I treat myelofibrosis patients and perform allogeneic metabolic stem cell transplants in those patients. At ASH we are presenting an abstract from retrospective analysis in the largest transplant registry, CIBMTR. We looked at 872 patients with myelofibrosis who underwent allogeneic metabolic stem cell transplant. And we wanted to look at the outcomes in patients who are over the age of 70 years. So in that data set out of 872 patients, we found 51 patients who were over the age of 70. Among those, the median age or the average age was 72 years, 92% for Caucasians. And most patients had intermediate to high risk, meaning the disease was high risk. And if you don't do a transplant in this setting, the survival is limited. It's measured in the order of months and is often less than a year. So in those patients, we found that at two years, 59% of them were still alive. They were disease free. 31% patients were disease free at two year mark. So despite slightly inferior outcomes compared to their younger counterparts, this over half of the patients surviving beyond two years are still very encouraging outcomes. So we think that allogeneic metabolic stem cell transplant should be offered to elderly myelofibrosis patients if they are fit and not frail and can undergo the transplant safely. The current guidelines will state that over the age of 65 years, the transplant should only be considered in the context of clinical efficacy study. And there has been a lot of debate going on. To continue this same work, so we are going to look at outcomes in patients who are over age 65 years. And we hope to publish those results soon. But I expect that these will be even better than the 70 year patient population. And few more points in that data set that we also looked at some of the other factors. So the Hispanic population compared to Caucasians has inferior outcomes. It has to do with social support, health system access issues, and use of mismatched unrelated donors as compared to matched sibling donors or matched unrelated donors had inferior outcomes. So with the right kind of patient selection, I think myelofibrosis patients over the age of 65 years who currently are not offered transplant routinely should get a transplant. I think there is a potential and age as we see in other diseases that it's more about the patient fitness. So just restricting at a certain number is probably not the right thing to do.
HealthTree • December 19, 2024