To Transplant or Not: Clinical Decisions in Elderly Patients with AML

Although intensive induction chemotherapy can lead to complete remission rates of 40-60% in elderly patients with acute myeloid leukemia (AML), median survival is typically less than 12 months, according to the authors of this review article. The authors’ review challenges a common perception that older patients cannot tolerate intensive therapies. Evaluation of recent research demonstrates that older age per se is not a contraindication for allogeneic hematopoietic cell transplantation (HCT), and that high comorbidity index score and poor performance status are more predictive of poor outcomes. They conclude that HCT is feasible and can provide approximately 40% survival at two years in select older patients and note that “the short duration of CR demands that leukemia and transplant physicians collaborate immediately after diagnosis to move quickly toward HCT.”

Ustun C, et al. Bone Marrow Transplant