Is there an upper age limit for HSCT procedures?

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Is there an upper age limit for HSCT procedures?

Postby KateCW » Mon Oct 17, 2011 9:51 pm

I am just wondering if places like Cleveland etc. Have a cut off age? I am almost 48. Thanks.
Kathy, 49 with PPMS,full time scooter.
Married to a wonderful man, mother to a darling 9 yr old boy
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Re: Is there an upper age limit for HSCT procedures?

Postby georgegoss » Tue Oct 18, 2011 11:04 am

KateCW wrote:I am just wondering if places like Cleveland etc. Have a cut off age? I am almost 48. Thanks.

Hi Kate,

I'm not aware of HSCT being offered at Cleveland.

But on the topic of HSCT and age. . . . first off. . . . 48 years of age shouldn't exclude you from any HSCT treatment. I was 45 when I went through my own myeloablative HSCT and Asher was 46 (or 47?) when he went through the same procedure. We both made it through the treatment and survived fine. The more important factor is the general health of the patient, independant of age.

With that said. . . . myeloablative HSCT is a very aggressive therapy and is quite hard on the body. I think most hospitals would have an age cutoff for older patients, probably (only my guestimate) around the age of 60 for most facilities.

However, the non-myeloabltive HSCT protocol is a gentler procedure and likely has no age restriction (even though the procedure will still make the patient feel quite ill and lose all their hair. . . after all, it's still chemotherapy which is necessary to stop the underlying MS disease activity).

Here is what Slavin / CTCI states on their website that makes complete sense to me:

Standard [myeloablative] BMT [HSCT] Procedures

A fully myeloablative bone marrow transplantation procedure must be performed in a hospital under clean and isolated conditions since the patient's own immune system is destroyed by the process, and the patient has no natural defenses during the period it takes for the transplanted stem cells to create new functioning white blood cells and the immune system. This procedure is difficult for patients and can only be offered to those who can withstand the rigors involved. Myeloablative BMT is generally not offered to patients over age 60.

"Mini Transplant" [non-myeloablative HSCT] – A Milder Treatment

This procedure was developed by Professor Shimon Slavin in the 1980s, followed by clinical application of RIC and NST in the 1990s. The nonmyeloablative stem cell transplant (NST) is much easier to tolerate and can be performed on an outpatient basis with few side-effects for the recipient. The procedure can be applied to elderly individuals with no upper age limit and is also suitable for use for patients in less than optimal clinical condition. In children and young adults, fertility is retained. The transplant procedure is not associated with severe side effects such as cataract formation and impairment of growth and development in children. Tests before the procedure may take a number of days, and tests to monitor the effectiveness of the procedure are performed periodically over several months. However, side effects are generally mild and hospitalization for them is infrequent.
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Re: Is there an upper age limit for HSCT procedures?

Postby Asher » Wed Oct 19, 2011 1:36 am

Asher was 48 and was branded young by the prof. that oversaw my HSCT at the Heidelberg university hospital, Germany.
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Re: Is there an upper age limit for HSCT procedures?

Postby HUD45 » Wed Oct 19, 2011 6:11 am

Hi Kate. I only have first hand knowledge with two providors of HSCT. In both cases from what I recollect in applications and discussions with CTCI in Israel and Heidelberg U. Hospital, is that after age 55 patients will receive much more pretreatment scrutiny to determine their ability to withstand the rigors of either myleoblative or non-myeloblative protocols of HSCT. In either case prospective patients will have to undergo a battery of blood tests as well as passing a pulmonary function and heart examination to determine fitness for treatment....HUD
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Re: Is there an upper age limit for HSCT procedures?

Postby KateCW » Wed Oct 19, 2011 6:24 am

Thanks everyone. That is encouraging as we are probably a couple of years away from treatment being even a remote financial possibility. Obviously going into treatment in the best possible health is an advantage. Perhaps this can motivate me to finally lose the weight that has packed on while riding around on this scooter!
Kathy, 49 with PPMS,full time scooter.
Married to a wonderful man, mother to a darling 9 yr old boy
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