A type of allogeneic hematopoietic stem cell transplantation (allo-HCT) designed to reduce graft vs host disease increased toxicity in older patients, according to a retrospective analysis involving 200 individuals. Participants ≥60 (n=80) and <60 (n=120) years of age underwent CD34+ selection allo-HCT between 2006 and 2012. Investigators looked at grade 3-5 toxicities. Among the results:

• The most common toxicities by day 100 in patients ≥60 were metabolic (88%), infectious (84%), hematologic (80%), oral/gastrointestinal (48%), cardiovascular (35%), and hepatic (25%).
• Patients in the older group were more than twice as likely to experience neurologic and 65% more likely to experience cardiovascular toxicities.
• They were 42% less likely to experience oral/GI toxicity.
• After adjusting for age and HCT-CI, cardiovascular, hepatic, neurologic, pulmonary, and renal toxicities remained independent risk factors for overall survival and non-relapse mortality.

The authors noted that the increased toxicity is potentially balanced by the absence of toxicity related to use of methotrexate and calcineurin inhibitors.