@article{ref1,
title="Allogeneic stem cell transplantation in patients above 55: Suggestion for a further stratification of the HCT-CI",
journal="Journal of cancer research and clinical oncology",
year="2014",
author="Späth, C. and Busemann, C. and Krüger, W.H.",
volume="140",
number="11",
pages="1981-1988",
abstract="INTRODUCTION: Allogeneic stem cell transplantation (alloSCT) has become available for elderly patients or for patients with comorbidities by introduction of reduced-intense conditioning. Comorbidity-related prognosis after alloSCT can be estimated by the hematopoietic cell transplantation comorbidity index (HCT-CI).; Material and Methods: The charts from 85 patients who have undergone 90 alloSCTs between 1999 and 2011 were analysed. Most patients received a dose-reduced conditioning and a graft from an unrelated donor. Patients were stratified for age, HCT-CI, cGvHD versus no cGvHD, and a modified HCT-CI with a further split high-risk score.; Results: Age over 60 years did not affect the outcome. Manifestation of cGvHD improved the prognosis significantly. An additional stratification of the high-risk group of the HCT-CI revealed that even a fraction of these patients can have considerable benefit from an alloSCT. Furthermore, this high-risk collective could be clearly discriminated into two groups with different outcomes.; Conclusions: The investigation confirms that age is no absolute risk factor for alloSCT and demonstrates the heterogeneity of the high-risk group of the HCT-CI. A comprehensive investigation of an additional stratification is suggested. Furthermore, the authors encourage early withdrawal of immunosuppression, even in elderly patients and patients with comorbidities to permit graft-versus-leukaemia/lymphoma, since cGvHD is associated with a significantly better prognosis. © 2014, Springer-Verlag Berlin Heidelberg.<p /><p>Language: en</p>",
language="en",
issn="0171-5216",
doi="10.1007/s00432-014-1748-6",
url="http://dx.doi.org/10.1007/s00432-014-1748-6"
}