Blood and bone marrow transplant innovation is increasing access to life-saving procedures for many older cancer patients. People with blood cancers and some other conditions have been treated with blood and bone marrow transplants (BMTs) for more than 40 years, but initially, only relatively-young patients were eligible. “There was a bar set as low as 40 years old when this was a brand-new technology,” says Sarah Wall, MD, MPH, a hematologist at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute. “Then it was 55 and 60 and 65, and now there is no official upper-age cutoff — it comes down to the individual patient. Click here to learn more about blood and bone marrow transplantation at The Ohio State University. As advancements in techniques and technology made BMT more widely available, Wall and her Ohio State colleagues opened The James Cancer and Aging Resiliency (CARE) Clinic to address the unique needs of older transplant patients. The CARE Clinic team assesses each older patient individually to determine their eligibility for a BMT. “We’ve shifted to more of a fitness — or physiological — assessment, she says. “Are they independent in their daily living and doing regular exercise and do they have good cardiovascular fitness? We also look at their support systems and caregivers to ensure they have someone to help them get through the treatment.” Click here to learn more about the CARE Clinic at the OSUCCC – James. Among the issues that have traditionally prevented older patients from undergoing BMT procedures are potential side effects like graft-versus-host-disease (GVHD), which can result from allogenic processes that involve the transplantation of cells from donors (transplants can also be autologous, which utilize patients’ own stem cells). Improvements in the treatment of GVHD and other potential barriers to transplantation have been game changers in the effort to increase the age range of BMT. “New therapies have really expanded the pool of donors for older adults who may only have siblings who are deceased or have had cancer themselves previously or some other disease that would make them ineligible,” Wall explains. “We have better drugs to prevent graft-versus-host-disease and to treat it when it does happen.” Several patients 70 and older have now been treated with BMT at The James. Wall’s oldest transplant patient is 80. “The first three gentlemen 70 and older who I treated with transplants are all coming up on their five-year anniversaries,” she says. “It’s a testament to them and their families and caregiver support that they got through this. We’re the scaffolding they build this support on, and it’s very rewarding to be part of this, and especially to open doors for people who thought they were closed.” Dr. Wall shares all the details about blood and bone marrow transplantation for older patients on our Cancer-Free World Podcast. Watch via the video player above, or click here to listen on SoundCloud.