Old, young fare just as well with bone marrow transplants

Contrary to what some researchers expected, a study led by the University of Minnesota found that older and younger patients fare just as well after receiving bone marrow transplants.

The study was presented at the American Society of Hematology meeting in San Francisco Monday by University researchers Brian McClune and Daniel Weisdorf, who is also director of the Blood and Marrow Transplant program.

This study analyzed the ages and outcomes of more than 1,000 patients aged 40 and older who received a bone marrow transplant for treatment of acute myeloid leukemia, known as AML and myelodysplastic syndrome, or MDS.

Weisdorf said he was a little surprised about the results of the study.

“I think we were all surprised,” he said. “We’re not arguing that transplant patients are better candidates when they’re 60 than they’re 40, but we saw no measurable statistical difference.”

Armand Keating, secretary of the American Society of Hematolog y, was also involved with the research. He said he was surprised by the results as well.

“The only factors that were important were the extent of the disease and the status of the patient,” he said. “It looks like older patients do just as well as their younger cohorts.”

Blood and marrow transplants are normally not offered to older patients due to concerns about their well-being after the transplant, Weisdorf said.

“It’s intense and it’s complicated treatment,” he said, “so in the past people were reluctant to apply such therapy to older adults.”

Weisdorf said he is presenting the results of this study to the Centers of Medicare and Medicaid Services, citing that Medicare does not cover the cost of a bone marrow transplant for patients with MDS.

“That’s not a deliberate decision by Medicare by any means, it’s just that no one has presented sufficient compelling data to Medicare,” he said.

Weisdorf said Meidcare should cover treatments for MDS.

“There is no curative therapy for myelodysplastic syndrome except a donor transplant,” he said. “Because the average age of the disease is in the 60s, people have not explored transplants in large numbers.”

The average age of someone with AML is 65. Keating said because of this, there needs to be attention placed on treatment of older adults.

“The reason that this is of significance is because blood and marrow transplantation is not offered to these people by and large,” he said.