Feasibility of autologous peripheral blood stem cell transplantation in elderly patients with acute myeloid leukemia.
Most studies showing that autologous stem cell transplantation (ASCT) is feasible in older patients with acute myeloid leukemia (AML) referred to highly selected patients considered as eligible after complete remission (CR) achievement and bone marrow or peripheral blood stem cell (PBSC) collection. This study evaluated the feasibility of ASCT from 155 consecutive AML patients aged over 60 years (median age 72 years, range 61 - 94) programmed to receive ASCT by using PBSCs after CR achievement. Overall, 90 out of 155 patients (58%) were judged as eligible for aggressive chemotherapy and 45 (50%) achieved CR. Among these, 36 (80%) received consolidation and 32 (89% of consolidated) were monitored for PBSC mobilization. A successful collection was registered in 25/32 patients (78% of monitored). Finally, 20 patients received ASCT. Reasons for not autografting five mobilizing patients included relapse pre-ASCT, toxicity, and refusal. Median survival was 4 months for the whole patient population and 19 months for patients actually autografted. Overall, 20 out of 90 patients accrued into intensive chemotherapy (22%) and 20 out of the entire patient population (13%) underwent ASCT. It is concluded that APBSCT can result in an improvement of therapeutic results in AML of the elderly, but it is feasible in a minority of selected patients.
Ferrara
Felicetto
F
Division of Haematology and Stem cell Transplantation Unit, Cardarelli Hospital, Naples, Italy. felicettoferrara@katamail.com
Palmieri
Salvatore
S
Celentano
Maria
M
De Simone
Mariacarla
M
Pollio
Filiberto
F
D'Amico
Maria Rosaria
MR
Copia
Carolina
C
Mele
Giuseppina
G
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007951:Leukemia, Myeloid / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D012074:Remission Induction; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000970:Antineoplastic Agents