Can a Patient Be Too Old for Stem Cell Transplant?

• Stem cell transplant is a potential curative treatment for patients with blood cancers and other life-threatening blood disorders.

  Selected patients may achieve long-term control of their disease, even if they have run out of treatment options. However, the best outcomes are usually obtained from early transplant for patients with high risk of disease.

  Because stem cell transplant is a major procedure, some doctors believe their patients are too old to undergo transplant. Ironically, the median age at diagnosis for most blood cancers is 65-70, which includes acute myeloid leukemia (AML), Non-Hodgkins lymphoma (NHL) and multiple myeloma.

  Recent studies have clearly demonstrated that older patients reported similar benefits from transplant when compared with younger patients. There is no clear way to define “young” or “old” when it comes to patients. For instance, while 50 would be considered relatively young for a blood cancer, a 50-year old patient who smoked heavily would be a poor candidate for transplant. On the other hand, an 80-year-old patient in excellent health might be an optimal candidate.

  Older patients may find their general health deteriorates during multiple courses of chemotherapy and thus, they may not be a candidate for transplant. To summarize, age should never be the sole factor in determining a patient’s eligibility for a transplant. Patients as old as 80 could be considered for transplant if it is early in the course of treatment. Other indications include disease progression and overall health. A transplant specialist and a medical oncologist will work together to determine the best course of treatment for each individual patient with the goal of obtaining the best outcome.