期刊
STEM CELLS TRANSLATIONAL MEDICINE
卷 11, 期 5, 页码 461-477出版社
OXFORD UNIV PRESS
DOI: 10.1093/stcltm/szac015
关键词
hematopoietic stem cell transplantation; acute myelogenous leukemia; elderly patients; comorbidity index; geriatric assessment; conditioning regimen; GVHD prophylaxis; donor selection; new drugs
资金
- Belgian Foundation against Cancer (FBC)
- National Fund for Scientific Research (FNRS)
- Anti-Cancer Center
- Leon Fredericq Foundation from the University of Liege
AlloHSCT offers the best chance for durable remission in older patients with AML, but it remains a difficult decision for hematologists due to potential toxicity and complex needs.
As in younger patients, allogeneic stem cell transplantation (alloHSCT) offers the best chance for durable remission in older patients (>= 60 years) with acute myeloid leukemia (AML). However, defining the best treatment strategy (and in particular, whether or not to proceed to alloHSCT) for elderly patients with AML remains a difficult decision for the hematologist, since potential toxicity of conditioning regimens, risks of graft-versus-host disease, impaired immune reconstitution and the need for prolonged immunosuppression may be of major concern in these vulnerable patients with complex needs. Hopefully, significant progress has been made over the past decade in alloHSCT for elderly patients and current evidence suggests that chronological age per se (between 60 and 75) is not a reliable predictor of outcome after alloHSCT. Here, we review the current state of alloHSCT in elderly patients with AML and also discuss the different approaches currently being investigated to improve both accessibility to as well as success of alloHSCT in these patients.
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