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Increasing Age and Survival After Bone Marrow Transplant-Reply

Olle Ringdén, MD, PhD; Mary M. Horowitz, MD, MS; Mortimer M. Bortin, MD
JAMA. 1993;270(21):2560. doi:10.1001/jama.1993.03510210046025.
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In Reply.  —The conclusion that age does not adversely affect outcome after allogeneic bone marrow transplantation in patients with leukemia is based on our findings in patients with early and intermediate disease. In these groups, the leukemia-free survival rate (95% confidence interval) at 2 years was 57% (37% to 75%) and 25% (6% to 65%), respectively. This is not significantly different from the corresponding figures of 51% (47% to 55%) and 32% (26% to 39%) in patients 30 to 39 years of age. The small numbers of subjects 50 years and older with advanced leukemia limited our ability to detect differences in this group. This we indicated in our report.Based on Karnofsky scores, duration of disease, and absence of infection prior to transplant, we found no evidence of a selection bias in transplant recipients older than 50 years compared with younger patients. However, transplant recipients are a select group,


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