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

Olle Ringdén, Ariane Boumendil, Myriam Labopin, Jonathan Canaani, Dietrich Beelen, Gerhard Ehninger, Dietger Niederwieser, Jurgen Finke, Matthias Stelljes, Armin Gerbitz, Arnold Ganser, Nicolaus Kröger, Lothar Kantz, Arne Brecht, Bipin Savani, Behnam Sadeghi, Mohamad Mohty, Arnon Nagler

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1975-1983
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume25
Issue number10
DOIs
StatePublished - Oct 2019
Externally publishedYes

Keywords

  • Acute myelogenous leukemia
  • Allogeneic hematopoietic stem cell transplantation
  • Elderly
  • Graft-versus-host disease
  • Leukemia-free survival

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