Age and Bone Marrow Transplantation

May 6, 2024 
This page was reviewed under our medical and editorial policy by Leslie Popplewell, M.D., Hematologist and Medical Director of Hematology and Blood and Bone Marrow Transplant, City of Hope Atlanta

Blood stem cell and bone marrow transplants may be a treatment option for patients with certain blood cancers, also called hematologic malignancies. Some patients may have questions about whether there’s an age limit for bone marrow transplant.

Standard Age Limitations in Bone Marrow Transplant

When first introduced in the 1970s, bone marrow transplantation was limited largely to younger patients due to the potential risk to patients who had to undergo intensive chemotherapy before receiving stem cells.

Since then, doctors have learned to perform transplants using a lower-intensity chemotherapy with fewer side effects. Supportive care has improved, as have methods of determining which patients would most benefit from this treatment. Age no longer automatically excludes patients from undergoing a bone marrow transplant procedure.

Besides age, the health care team may also consider:

  • Does the patient have a good support system — including for psychological, emotional, practical and financial needs — in place? A caregiver may need to stay with the patient 24/7 for up to 100 days.
  • Is the patient able to cope with the physical and mental demands of a transplant at their age and the state of their health?
  • Most importantly, do the benefits of such a transplant outweigh the risks for this patient?

Expanding Access to Bone Marrow Transplants for Aging Adults

Safely expanding the age limits for bone marrow transplants is important because most blood cancers are typically diagnosed in adults when they reach their late 60s and early 70s. With baby boomers aging, the U.S. population of 60- and 70-year-olds is expanding rapidly and the number of patients 65 and older is expected to double by 2030. Between 2010 and 2030, the incidence of cancer in people aged 65 and older is projected to increase 67%. That’s six times the 11% incidence of cancer rate for people younger than 65.

City of Hope’s Center for Cancer and Aging focuses on the unique health needs of older patients living with cancer, and it’s one of the few research facilities that focus specifically on the distinct issues facing older patients with cancer. Such issues include the impact of age-related declines in body functions and being on multiple medications. Other issues include comorbid medical conditions patients may have and how that impacts their tolerance for cancer treatments.

The Center for Cancer and Aging’s mission is to connect experts from across all cancer disciplines and work on studying the treatment, biology and survivorship problems that face older adults living with cancer. The center’s bone marrow transplant research results may potentially impact the majority of patients with cancer, as about 60% of cancer diagnoses and about 70% of cancer deaths happen in patients with cancer who are older than 65, according to the Center for Cancer and Aging.

Learn about City of Hope’s Aging and Blood Cancers Clinic

Bone Marrow Transplant Patient Stories

City of Hope patient Susan Reid underwent a stem cell transplant at the age of 72 to treat a rare blood cancer called myelofibrosis. Six months after the procedure, her pain level dropped, and now she is working with occupational therapists to maintain mobility. “Some people don’t make it to 72,” she said. “I feel so fortunate because I’m here, and I’m doing really well. And it brings joy because these little stem cells are working in my bone marrow to make me better, day by day.”

At 67, City of Hope patient Wendell Liljedahl underwent a bone marrow transplant to treat myelodysplastic syndromes (MDS). His donor was a 25-year-old man in Germany, who was a perfect match. In 2022, the men and their families met face-to-face for the first time. “It was so gratifying to finally meet and hug them in person,” said Liljedahl. “He was a 25-year-old kid who decided to give of himself to save another human being.”

References
References
  • American Society of Clinical Oncology (2018, August 21). Bone Marrow Transplants and Older Adults: 3 Important Questions. 
    https://www.cancer.net/blog/2018-08/bone-marrow-transplants-and-older-adults-3-important-questions

  • City of Hope. Center for Cancer and Aging. 
    https://www.cityofhope.org/research/beckman-research-institute/center-for-cancer-and-aging

  • Clinicaltrials.gov (2011, September 21). Assessment of Older Adults with Cancer: Feasibility of Computer Survey Methodology. 
    https://clinicaltrials.gov/study/NCT00977834