title: Factors prognostic of eligibility for allogeneic HCT among older patients with AML-CR1 and adverse- or intermediate-risk cytogenetics.
abstract: The introduction of reduced-intensity conditioning (RIC) regimens has made possible allogeneic hematopoietic cell transplantation (allo-HCT) in older patients with acute myeloid leukemia (AML). However, the optimal timing of allo-HCT in these patients and its relative risks and benefits when compared with chemotherapies have not been determined. This retrospective study by the Fukuoka Blood and Marrow Transplant Group compared RIC allo-HSCT with non-transplant therapies, the choice based on donor availability, in AML patients in their first complete remission (CR1). The prognostic value of various patient characteristics and disease-specific variables were investigated in 299 patients aged ≥60 years with AML in CR1. Among the 107 patients aged 60-65 years, 54 of whom received allo-HCT and 53 of whom continued chemotherapies; allo-HCT, adverse-risk group, and hematopoietic cell transplantation-comorbidity index were significant predictors of survival outcomes. Among 192 patients aged ≥66 years deemed ineligible for allo-HCT, relapse and Karnofsky performance status after induction therapy were significant predictors of survival outcomes. Findings from this study may facilitate a new standard of care for older AML patients in CR1 who are considered candidates for allo-HCT.
authors.affiliation: Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan, yamas009@kyumed.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Goichi
authors.initials: G
authors.lastname: Yoshimoto
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ogawa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Aoki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Higuchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Harada
authors.forename: Fumito
authors.initials: F
authors.lastname: Arima
authors.forename: Seiji
authors.initials: S
authors.lastname: Kondo
authors.forename: Fujio
authors.initials: F
authors.lastname: Matubara
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takahashi
authors.forename: Naokuni
authors.initials: N
authors.lastname: Uike
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Seiichi
authors.initials: S
authors.lastname: Okamura
authors.forename: Koichi
authors.initials: K
authors.lastname: Akashi
mesh_terms: D000368:Aged; D020732:Cytogenetic Analysis / Q000379:methods*; D004608:Eligibility Determination / Q000379:methods*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods