Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in Patients Age >69 Years with Acute Myelogenous Leukemia: On Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
Reduced-intensity conditioning (RIC) allows for the use of allogeneic hematopoietic stem cell transplantation (HSCT) in older patients with acute myelogenous leukemia (AML). We compared outcomes between 713 patients age ≥70 years and 16,161 patients age 50 to 69 years who underwent HSCT between 2004 and 2014. A higher proportion of the older patients were male and had secondary AML, active disease, a peripheral blood stem cell graft, a matched unrelated donor, an RIC regimen, and a lower Karnofsky Performance Status (KPS) score (P< .001). In multivariate analysis, the incidences of acute and chronic graft-versus-host disease and relapse were similar in the 2 age groups. Nonrelapse mortality at 2 years was 34% (95% confidence interval [CI], 31% to 38%) in patients age ≥70 years and 24% (95% CI, 25% to 32%) in those age 50 to 69 years (P< .001). Survival at 2 years in the 2 groups was 38% (95% CI, 34% to 42%) and 50% (95% CI, 49% to 50%), respectively (P< .001). In patients with active disease, the corresponding percentages were 35% (95% CI, 29% to 41%) in those age ≥70 years and 33% (95% CI, 31% to 34%) in those age <70 years (P = .36). In patients age ≥70 years, a KPS score of ≥80% was associated with improved survival (hazard ratio, 1.53; 95% CI, 1.14 to 2.06; P = .003). In summary, patients age ≥70 years had worse outcomes, except for those with active AML.
['Ringdén|Olle|O|', 'Boumendil|Ariane|A|', 'Labopin|Myriam|M|', 'Canaani|Jonathan|J|', 'Beelen|Dietrich|D|', 'Ehninger|Gerhard|G|', 'Niederwieser|Dietger|D|', 'Finke|Jurgen|J|', 'Stelljes|Matthias|M|', 'Gerbitz|Armin|A|', 'Ganser|Arnold|A|', 'Kröger|Nicolaus|N|', 'Kantz|Lothar|L|', 'Brecht|Arne|A|', 'Savani|Bipin|B|', 'Sadeghi|Behnam|B|', 'Mohty|Mohamad|M|', 'Nagler|Arnon|A|']
D000368:Aged D005060:Europe D005260:Female D018380:Hematopoietic Stem Cell Transplantation D006801:Humans D008297:Male D008875:Middle Aged D012189:Retrospective Studies D015996:Survival Rate D019172:Transplantation Conditioning D014184:Transplantation, Homologous D016896:Treatment Outcome
Allogeneic hematopoietic stem cell transplantation Acute myelogenous leukemia Graft-versus-host disease Elderly Leukemia-free survival