Allogeneic stem-cell transplant is curative for some patients with acute myeloid leukemia (AML). However, not all patients are eligible. To aid the clinician in making treatment decisions, the treatment pathway for older patients with AML should take into account their disease risk, comorbidities, and effectiveness of treatment in improving survival.
Researchers conducted a retrospective analysis of 118 patients over age 65 years diagnosed with AML. Patients receiving therapy (n = 90) were categorized into 2 groups: those receiving intensive induction therapy and those receiving induction therapy with a hypomethylating agent. Regarding comorbidities, the 2 groups were similar. Seventy-one patients were categorized as poor risk; 25 (35%) of these patients underwent allogeneic stem-cell transplant. All patients who underwent transplantation had achieved complete remission, whereas 8 patients in complete remission did not proceed to transplantation.
In terms of study results, across pooled risk groups, transplant was associated with improved median survival (34.6 months; P <0.001), compared with induction therapy without transplant (6.5 months), regardless of induction regimen. The survival advantage was greatest in the poor-risk group (39.6 months with transplant vs 6.1 months without transplant). Patient age and chemotherapy regimen (including hypomethylating agents) did not affect median survival in this analysis.
Researchers concluded that allogeneic stem-cell transplant can be safely performed in patients >70 years of age, and that transplant confers a significant survival advantage compared with chemotherapy alone.
Lachowiez CA, et al. ASCO Abstract 7048.