The Open Leukemia Journal

2010, 3 : 55-59
Published online 2010 September 8. DOI: 10.2174/1876816401003010055
Publisher ID: TOLEUKEMIAJ-3-55

RESEARCH ARTICLE
 Feasibility and Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in 30 Patients with Poor Risk Acute Myeloid Leukemia Older than 60 Years

Candoni Anna, * , Simeone Erica , Cerno Michela , Sperotto Alessandra and Fanin Renato
Division of Haematology and Bone Marrow Transplantation, Department of Medical and Morphological Researches (DMMR), University of Udine, Italy

* Address correspondence to this author at the Division of Hematology and Bone Marrow Transplantation Unit, University of Udine, Italy; Tel: 0432-559662; Fax: 0432 559661; E-mail: candoni.anna@aoud.sanita.fvg.it

ABSTRACT

We report on the feasibility and outcome of allogeneic SCT (allo-SCT) in 30 poor risk AML patients older than 60 years. Median age at transplant was 63 years (range 60-70 years) and 18/30 (60%) cases were in complete remission. Donors were MUD in 40% and sibling in 60% of cases. Twenty-six of 30 patients (87%) received a reduced intensity conditioning regimen (RIC). The hematopoietic cell transplantation specific comorbidity index (HCT-CI) was two or less in 12/30 cases and three or more in 18/30 cases. All patients engrafted. One year Nonrelapse mortality (NRM) rate was 20% (6/30 cases). After a median follow-up of 16 months 17/30 patients (57%) were alive and in complete remission while 13/30 (43%) have died (leukemia refractory or relapse 7/13 and NRM 6/13). Median Overall Survival for the whole patient population was 28 months. The Overall Survival did not differ between unrelated and related donors. The patients transplanted in complete remission had a significantly lower survival rate and relapse rate compared to those transplanted with refractory or relapsed AML (P= 0.0004 and P= 0.008 respectively). The patients with a low HCT-CI (2 or less) had a significantly lower NRM (P = 0.03) and survival rate (P = 0.02) compared to those with HCT-CI 3 or more.

Taking into account that this is a retrospective analysis with a small number of cases, these results confirm the feasibility of allo-SCT for high risk AML patients older than 60 years. Outcome was significantly influenced by status of disease at transplant and by HCT-CI. We also confirm that for older patients lacking a family donor MUD can provide a suitable alternative option.

Keywords:

Acute leukemia, hematopoietic stem cell transplantation, comorbidity index.