The Community Focus Channel on VJHemOnc is an independent medical education platform, supported with funding from Johnson & Johnson (Gold). Supporters have no influence on the production of content. The levels of sponsorship listed are reflective of the amount of funding given.
The Lymphoma Channel on VJHemOnc is an independent medical education platform, supported with funding from AstraZeneca (Diamond), BMS (Gold), Johnson & Johnson (Gold), Takeda (Silver) and Galapagos (Bronze). Supporters have no influence on the production of content. The levels of sponsorship listed are reflective of the amount of funding given.
EBMT 2025 | Assessing the eligibility of older patients for transplant or cellular therapy
In this video, Parastoo Dahi, MD, MS, Memorial Sloan Kettering, New York City, NY, emphasizes the importance of not excluding older patients with hematological malignancies from stem cell transplantation and cellular therapy based on age alone. She highlights the need to consider physical function, cognitive function, comorbidities, and the patient’s overall fitness when making treatment decisions. Geriatric assessment helps identify vulnerabilities and determine whether any interventions can be implemented to improve fitness prior to treatment. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript
Transplant and cellular therapy in general, I think, have been underutilized in older patients with blood cancer based on the perception that older patients cannot tolerate these treatments. And this is one of the major barriers to referrals by community oncologists. But as we know, blood cancers such as lymphoma are primarily diseases of older patients. And given the significant prognostic impact of cellular therapies in younger patients and prospective studies, omitting this treatment based upon age alone could potentially affect survival in older patients...
Transplant and cellular therapy in general, I think, have been underutilized in older patients with blood cancer based on the perception that older patients cannot tolerate these treatments. And this is one of the major barriers to referrals by community oncologists. But as we know, blood cancers such as lymphoma are primarily diseases of older patients. And given the significant prognostic impact of cellular therapies in younger patients and prospective studies, omitting this treatment based upon age alone could potentially affect survival in older patients.
So with the advances in the field of transplant and cellular therapy, including the modifications in the preparative regimens and improving the supportive measures, we know that we can offer and extend these treatments to older patients safely. So when evaluating patients for cellular therapy it’s important to move beyond age as the only factor for determination of suitability and consider other factors such as physical function, cognitive function, comorbidities, and overall health of that person.
A tool that has been useful to identify vulnerabilities in older patients is geriatric assessment, which will potentially allow for not only identifying what are the impairments or where are the vulnerabilities, but can we actually do anything about them? So potential interventions such as exercise programs or cognitive rehabilitation, et cetera, so that you improve their fitness prior to the cellular therapy.
The published data do not support routine exclusion of older patients for transplant or cellular therapy, especially in the cases where there is a clear benefit to these treatments, and the vast majority of survival events have been disease progression rather than toxicities from the treatments.
This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.
Read more...
