Allogeneic Hematopoietic Cell Transplantation for Older Adults with Acute Myeloid Leukemia

• Published in: Cancers Vol. 10; no. 6; p. 179
• Main Authors: Lipof, Jodi J, Loh, Kah Poh, O'Dwyer, Kristen, Liesveld, Jane L
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 04.06.2018; MDPI
• Subjects: Acute myeloid leukemia; Chemotherapy; Leukemia; Mortality; Myeloid leukemia; Patients; Review; Stem cell transplantation; Stem cells; Toxicity; Transplants & implants; acute myeloid leukemia; older adults; allogeneic stem cell transplantation
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers10060179

Acute myeloid leukemia (AML) is a disease that affects adults aged 65 years and above, and survival in this population is poor. Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapy for these patients but is underutilized due to frequent comorbidities and perceived higher risk of treatment-related mortality and non-relapse mortality. Increasing data supports the utility of allo-HCT in fit older patients after intensive chemotherapy resulting in improvement of outcomes. With the development of reduced intensity and non-myeloablative conditioning regimens that are associated with lower rates of treatment-related toxicity and mortality, this has allowed more older patients with AML to receive allo-HCT. In this review, we provide some guidance on appropriate selection of older patients as transplant candidates, benefits and risks associated with allo-HCT, conditioning regimen choice, and stem cell transplant sources as they relate to the conduct of stem cell transplantation in older patients.