Allogeneic hematopoietic cell transplantation for patients with AML aged 70 years or older in first remission. A study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

Enrico Maffini, Maud Ngoya, Jacques-Emmanuel Galimard, Samia Harbi, Nicolaus Kröger, Uwe Platzbecker, Henrik Sengeloev, Charles Craddock, Victoria Potter, Goda Choi, Patrice Chevallier, Friedrich Stölzel, Eleni Tholouli, Johan Maertens, Fabio Ciceri, Jan Cornelissen, Jaime Sanz, Alexandros Spyridonidis, Francesco Lanza, Arnon NaglerMohamad Mohty

Abstract

Accessibility to allogeneic hematopoietic cell transplantation (HCT) programs for older patients is growing constantly. We report on the clinical outcomes of a group of 701 adults aged ≥70 years, with acute myeloid leukemia (AML) in first complete remission (CR1), who received a first HCT, from HLA-matched sibling donors (MSD), 10/10 HLA-matched unrelated donors (UD), 9/10 HLA-mismatched unrelated donors (mUD) or haploidentical (Haplo) donors. The 2-year overall survival (OS) was 48.1%, leukemia-free survival (LFS) 45.3%, relapse incidence (RI) 25.2%, non-relapse mortality (NRM) 29.5% and GVHD-free, relapse-free survival (GRFS), 33.4%. Compared to MSD, patients transplanted from Haplo and UD presented lower RI (HR 0.46, 95% CI 0.25-0.8, p = 0.02 and HR 0.44, 95% CI: 0.28-0.69, p = 0.001, respectively); this translated into prolonged LFS for Haplo (HR 0.62, 95% CI: 0.39-0.99, p = 0.04). Patients transplanted from mUD exhibited the highest NRM incidence (HR 2.33, 95% CI: 1.26-4.31, p = 0.007). HCT in selected adult CR1 AML patients >70 years is feasible and could be associated with good clinical outcomes. Prospective clinical trials are warranted.

Original languageEnglish
JournalBone Marrow Transplantation
Volume58
Issue number9
Pages (from-to)1033-1041
Number of pages9
ISSN0268-3369
DOIs
Publication statusPublished - Sep 2023

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