Autologous stem-cell transplantation for patients with acute myeloid leukemia aged over 60 yr.
OBJECTIVE
Preliminary reports have suggested that autologous stem-cell transplantation (ASCT) is feasible in elderly patients with acute myeloid leukemia (AML). The objective of this study was to describe the disease characteristics and treatment results from a series of 22 elderly AML patients undergoing ASCT.


METHODS
The median age was 64 yr (range 61-71). Twenty patients were in first complete remission (CR1), two in CR2, and all were in performance status 0-1. The median interval between CR achievement and ACST was 3 months (range 2-5). In 20 cases peripheral blood stem cells were infused, in two bone marrow.


RESULTS
All patients had a successful engrafment. One patient (5%) died from transplant-related complications. The median number of days to granulocytes > 500 mm-3 and platelets > 20 000 mm-3 was 11(range 9-15) and 13 (range 9-20), respectively. Non-hematologic toxicity included WHO grade III-IV stomatitis in 32% patients and grade IV nausea and vomiting in one (4.5%). Seven patients had fever of unknown origin, while in 14 a documented infection was diagnosed. Median duration of hospitalization was 31 d (range 16-60).


CONCLUSIONS
After a median follow-up of 12 months from ASCT, nine patients are alive in continuous CR and 13 died from AML relapse. Median survival from diagnosis and disease-free survival (DFS) was 19 and 14 months, respectively. Our data show that ASCT with a standard conditioning regimen is feasible in AML patients aged more than 60 yr. Toxicity and hemopoietic recovery do not substantially differ from those observed in young adults. DFS and overall survival (OS) duration are encouraging, but a longer follow up is needed on a larger series of patients.
Ferrara
Felicetto
F
Divisione di Ematologia, A.O.R.N. A.Cardarelli, Via Niccolò Piccinni 6, 80126 Naples, Italy. felicettoferrara@katamail.com
Venditti
Adriano
A
Carellajr
Angelo Michele
AM
Cantore
Nicola
N
Buccisano
Francesco
F
Tamburini
Anna
A
Palmieri
Salvatore
S
Mele
Giuseppina
G
Annunziata
Mario
M
Greco
Michele Mario
MM
Amadori
Sergio
S
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D005260:Female; D006085:Graft Survival; D006801:Humans; D007951:Leukemia, Myeloid / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome