Too old for a BMT?

[jacqueline]

Hi there
My mum was diagnosed with MDS 6 years ago (when she was 60) and we have a appointment with her haem consultant this Friday. We are ready for the worst as my mum is now convinced she has developed AML, as her symptoms have changed drstically in the last couple of months ans she's not really ebeneifitting from transifusion (3 units every 3 weeks) as she once was.

I was just wonedring if anyone knows whether a BMT at her age - 66 - is plausible?

Many thanks Jacqui (Liverpool, England)

[Neil Cuadra]

When considering a transplant, age is a factor, along with overall health, the stage of the disease, the alternative treatment choices (e.g., drugs, transfusions), and the availability of a matched donor. Being age 66 does not rule out a transplant.

Patients in their 50s, 60s, and even 70s now make up a significant percentage of unrelated-donor transplant recipients, up significantly since the 1990s. I assume your mother doesn't have a matched donor, but if so that would make a transplant even less of a risk.

One of the reasons that older patients are able to have transplants is the use of non-myeloablative transplants or "mini transplants", which use less chemotherapy and little or no radiation. Transplants are still tough medicine, but recovery from a mini transplant tends to be much faster than from a full (myeloablative) transplant.

[jacqueline]

Thanks ever so much Neil. I wish we has been more pro-active when she was first diagnosed. She was at her peak, physically then - an avid rambler and regular at the gym/pool, but her consultant advised transfusion maintanencae and iron chelation, which, up until recently, has worked well - it's a steep learning curve getting to grips with the language of haematology!
We'll find out more at her looming 'big' appointemnt on Friday - fingers crossed!
Many many thanks for your help here
Jacqui

[Neil Cuadra]

Originally Posted by jacqueline

I wish we has been more pro-active when she was first diagnosed. She was at her peak, physically then - an avid rambler and regular at the gym/pool, but her consultant advised transfusion maintanencae and iron chelation, which, up until recently, has worked well

The fact that transfusions and chelation worked well for years means that it was a reasonable choice 6 years ago, especially when mini-transplants hadn't been studied as much and recommended as often. Without a crystal ball it's rare to have absolute certainty about the choice among treatments, so we and our doctors rely on the information available at the time.

You might want to follow the How did you decide if/when for the BMT? thread for more views from patients.

Your mother's regular exercise over the years put her at an advantage, and it probably still applies. Good luck!