title: Consolidation with autologous stem cell transplantation in first remission is safe and effective in AML patients above 65 years.
abstract: The outcome of AML patients ≥65 years remains disappointing. Current post-induction strategies for elderly AML patients fit for intensive treatment involve additional cycles of chemotherapy or allogeneic transplantation. Consolidation with autologous transplantation (ASCT) is poorly studied in these patients. In this single-center retrospective analysis, we determined survival rates of AML patients ≥65 years undergoing busulfan/cyclophosphamide conditioning before ASCT in first remission between 2007 and 2015. We found elderly AML patients with ASCT to have longer progression-free survival (PFS; 16.3 vs. 5.1 months, P=0.0166) and overall survival (OS; n.r. vs. 8.2 months; P=0.0255) than elderly AML patients without ASCT consolidation. In addition, elderly AML patients undergoing ASCT had comparable PFS (P=0.9462) and OS (P=0.7867) as AML patients below 65 years receiving ASCT consolidation in CR1. Our data suggest that ASCT is an option in elderly fit AML patients who appear to benefit from autologous consolidation similarly to younger AML patients.
authors.affiliation: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Heini
authors.affiliation: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Berger
authors.affiliation: Department of Clinical Research, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: Katja
authors.initials: K
authors.lastname: Seipel
authors.affiliation: Department of Hematology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: Behrouz Mansouri
authors.initials: BM
authors.lastname: Taleghani
authors.affiliation: Department of Hematology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Baerlocher
authors.affiliation: Department of Pediatric Hemato-Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: Kurt
authors.initials: K
authors.lastname: Leibundgut
authors.affiliation: Institute of Pathology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: Yara
authors.initials: Y
authors.lastname: Banz
authors.affiliation: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: Urban
authors.initials: U
authors.lastname: Novak
authors.affiliation: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland. Electronic address: thomas.pabst@insel.ch.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pabst
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002066:Busulfan / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D003520:Cyclophosphamide; D002066:Busulfan
keywords: AML; Autologous; Elderly; Survival; Transplant