Blood and marrow transplantation in elderly acute myeloid leukaemia patients – older certainly is not better

被引:0
作者
T L Kiss
W Sabry
H M Lazarus
J H Lipton
机构
[1] Maisonneuve Rosemont Hospital,Department of Hematology
[2] University of Montreal,undefined
[3] Comprehensive Cancer Center of Case Western Reserve University,undefined
[4] University Hospitals of Cleveland,undefined
[5] Allogeneic Blood and Marrow Transplant Program,undefined
[6] Princess Margaret Hospital,undefined
[7] University of Toronto,undefined
来源
Bone Marrow Transplantation | 2007年 / 40卷
关键词
elderly; acute myeloid leukaemia; stem cell transplantation; comorbidity;
D O I
暂无
中图分类号
学科分类号
摘要
Acute myeloid leukaemia in the elderly is a disease with distinct biological properties, commonly associated with leukaemic cell treatment resistance and with an increased number of high-risk features, including concomitant myelodysplasia and poor-risk cytogenetic abnormalities such as monosomy 5 and 7. Complete remission rates after standard induction chemotherapy in patients above age 60 years are less than 50%, with long-term survival rates below 10%. Post-remission stem cell transplant therapies have not been studied extensively. Autologous transplants can result in an acceptable 3-year leukaemia-free survival rate of up to 47%, yet this procedure is applicable only to a small minority of patients. Myeloablative allogeneic transplants similarly show feasibility in selected few patients and in general are very toxic. Non-myeloablative allogeneic transplants are associated with reduced toxicity, but are plagued by an increased relapse rate. The latter strategy appears promising, but must be validated in larger, multi-centre prospective trials, in which outcomes are compared to non-transplant approaches.
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页码:405 / 416
页数:11
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