ABSTRACT Our study includes 103 patients aged between 51 and 60 years who underwent allogeneic hematopoietic stem cell transplantation (allo‐HSCT) from matched sibling donors (MSDs) ( n = 36), haploidentical donors (HIDs) ( n = 56), and unrelated donors (URDs) ( n = 11). Multivariate analysis exploring the relationship between risk factors and survival confirmed that survival outcomes were only independently impacted by Eastern Cooperative Oncology Group (ECOG) score (ECOG scores ≥2 vs. ECOG scores of 0–1, overall survival OS HR: 2.91 95% CI 1.35–6.27, p = 0.006; failure free survival FFS HR: 2.93 95% CI 1.33–5.88, p = 0.006; graft‐versus‐host disease–free/relapse‐free survival GRFS HR: 2.80 95% CI 1.33–5.88, p = 0.006), while age, specific donor source and hematopoietic cell transplantation‐comorbidity index (HCT‐CI) score did not significantly influence prognosis in this age group. After applying propensity score‐matching (PSM) to balance the pretransplant clinical factors between patients with ECOG scores 0–1 cohort and those with ECOG scores ≥2 cohort, poor performance status remains a negative factor for survival outcomes (OS p = 0.04; FFS p = 0.03; GRFS p = 0.03). Further analysis in subgroup patients with HCT‐CI scores 0–1 found the retained significance of ECOG score in predicting inferior survival. In conclusion, our results indicate good long‐term results of allo‐HSCT in elderly SAA adults regardless of donor type. Higher ECOG score is associated with poor post‐transplant outcomes and has to be taken into account for patients, even at a low‐risk comorbidly burden.
Zhao et al. (Sun,) studied this question.