An 11-year retrospective study (2005-16) reported by Dr. Rice et al from King’s College Hospital, reviewing stem cell transplant (SCT) outcomes from the international bone marrow registry database in a cohort of patients 50+ years of age with aplastic anaemia (AA), has confirmed a sentiment we have long held – SCT is a very feasible option in a good proportion of patients who might be elderly, but are otherwise fit and healthy.

Campath-based treatment outcomes

Treatment guidelines for older patients with AA are incompletely developed, and SCT often remains a second line of therapy for patients either non-responsive or refractory to standard immune-suppressive treatment (IST). What this study underscores, is the ‘wellness’ of a person and it’s correlation to SCT outcomes. It further confirms, that a Campath (an antibody directed against the active immune cells from the donor) is associated with less morbidity from one of the significant complications of SCT, namely Graft versus Host Disease (GvHD). A seminal research paper, published by Prof. Judith Marsh and her group from King’s, had previously shown that Campath-based conditioning treatments in SCT, lead to significantly lower complications from GvHD, is safely tolerated, making this an attractive option. As transplant outcomes get better, a Campath-based conditioning treatment for SCT in patients with AA, as frontline therapy, even in patients greater than 50 years, needs to be systematically studied and holds promise for patients.

Interestingly, patients aged 65-78 years had outcomes similar to those aged between 50-64 years, so long as the ‘wellness’ of a person was matched between the two groups.