Transplantation Related Mortality Did Not Show Significant Differences in Patients Aged Above 55 Years With Hematological Malignancies Receiving Allogeneic Hematopoietic Stem Cell Transplantation in a Real-World Study.

Transplantation related mortality (TRM) remains an issue, particularly in older patients with hematological malignancies. In order to assess the TRM and the feasibility of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in older patients, we collected data from a total of 251 patients aged 55-70 years with acute hematological malignancies who received allo-HSCT from April 19, 2011 to June 28, 2022 in our hospital. With the median follow-up of 637 days, the cumulative incidence of TRM for patients above 55 years on Day 100, 1 year, and 2 years was 6.0%, 21.2%, and 26.7%, respectively. Forty-three (17.1%) patients died of TRM, of whom 11 patients died within 100 days after allo-HSCT, including two due to TMA, two due to aGVHD and TMA simultaneously, one due to capillary leak syndrome, and six due to infection. The cumulative incidence of TRM on Day 100, 1 year, and 2 years between the group aged 55-59 and 60-70 years did not show significant differences. Through a Cox regression analysis, platelet engraftment failure, conditioning regimen, grade 3-4 aGVHD, and cytomegalovirus disease were determined as risk factors for TRM in older patients. In conclusion, allo-HSCT is a feasible option for older patients with hematological malignancies.