Increasing Age and Survival After Bone Marrow Transplant

To the Editor.  —Ringdén et al¹ conclude that among patients with leukemia who are older than 30 years at the time of allogeneic bone marrow transplantation, increasing age into the fifth decade does not adversely affect outcome after transplants from HLA-identical siblings. This conclusion is based on results obtained in 2180 patients, only 80 of whom were older than 50 years. Ringdén et al admit that the patients were highly selected, since only data on transplanted patients reported to the International Bone Marrow Transplant Registry were analyzed. Despite this, their main conclusion is made without reservation. From Table 2 in the article it is clear that the leukemia-free survival rate in 45- to 49-year-old patients at 2 years with advanced leukemia was 3%, and the treatment-related mortality rate was 94%. Results in patients 50 years or older with advanced disease were not evaluated. For patients with an intermediate state