ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR ACUTE MYELOID LEUKEMIA OF THE ELDERLY: REVIEW OF THE LITERATURE AND PERSPECTIVES. Hematopoietic stem cell transplatation in the elderly fo Acute Myeloid Leukemia
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Keywords
acute myeloid leukemia, allogeneic stem cell transplantation, ,older patients,reduced intensity conditioning transplant, geriatric assessment, cytogenetic risk
Abstract
Acute myeloid leukemia (AML) in adults older than 60 years old has a poor prognosis. Elderly patients often present with comorbidities and an adverse biology of the disease, with higher genetic risk and chemoresistance. Allogeneic hematopoietic stem cell transplantation (HSCT) can be an effective treatment, and can improve overall survival (OS).Intensive chemotherapy (IC) before HSCT and myeloablative conditioning regimens can produce significant toxicity and transplant-related mortality (TRM). Reduced-intensity conditioning (RIC) or non-myeloablative (NMA) regimens appear to preserve the graft-versus-leukemia effect, and may improve survival. The increasing knowledge in AML of the elderly is currently being associated with a multidimensional approach to identify those patients eligible for targeted therapy, such as Flt3 inhibitors, and/or allogeneic HSCT.
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