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年龄对异基因造血细胞移植后住院和结局的影响:单中心经验。

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

机构信息

Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave., Toronto, ON, M5G 2M9, Canada.

Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.

出版信息

Ann Hematol. 2023 Apr;102(4):917-926. doi: 10.1007/s00277-023-05135-3. Epub 2023 Feb 23.

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 65 years (range, 60-76), between 2014 and 2019. We categorized them to 3 age groups (G): G1, 60-65 years (n = 175); G2, > 65-70 years (n = 127); and G3, > 70 years (n = 30). The median length of hospitalization during the initial HCT period was 30 days, with a significant difference when stratified by age (p = 0.049). Overall, 183 (58.7%) patients were re-hospitalized within the first 6 months 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 2 years was 25% in G1, 36% in G2, and 52% in G3 (p = 0.008). In multivariable analysis, patients aged 60-65 years had significantly better EFS (p = 0.04) and had a trend toward lower NRM (p = 0.05) than those aged > 70 years. Re-admission in the first 6 months 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 > 70 years have an inferior EFS and higher NRM. This likely related to higher rate of re-admissions due to infectious complications (84%).

摘要

在老年患者中,异基因造血细胞移植(HCT)的结果尚不清楚。我们回顾性分析了 2014 年至 2019 年间 332 例中位年龄为 65 岁(范围 60-76 岁)的患者的结果。我们将他们分为 3 个年龄组(G):G1,60-65 岁(n=175);G2,>65-70 岁(n=127);G3,>70 岁(n=30)。初次 HCT 期间住院中位时间为 30 天,按年龄分层有显著差异(p=0.049)。总体而言,183 例(58.7%)患者在 HCT 后 6 个月内再次住院,60 例(21.6%)在第二个 6 个月期间住院。G1、G2 和 G3 的 2 年 OS 分别为 56%、53%和 34%(p=0.05)。G1、G2 和 G3 的 2 年 EFS 分别为 54%、49%和 31%(p=0.04)。2 年 NRM 分别为 25%、36%和 52%(p=0.008)。多变量分析显示,60-65 岁患者的 EFS 显著更好(p=0.04),NRM 有降低趋势(p=0.05),而 60-65 岁患者的 EFS 显著更好(p=0.008)。HCT 后 6 个月内再次入院对 OS、EFS 和 NRM 有显著影响。HCT 特异性合并症指数>3 显著影响 NRM。最后,年龄对 HCT 期间的住院时间有显著影响。总之,年龄>70 岁的患者 EFS 较差,NRM 较高。这可能与因感染并发症(84%)导致再入院率较高有关。

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