AUTOLOGOUS STEM CELL TRANSPLANTATION IN ELDERLY ACUTE MYELOID LEUKEMIA

Treatment outcome in elderly Acute Myeloid Leukemia (AML) is still very disappointing. Although complete remission rate is around 50-60% the 2 years survival is only in the magnitude of 10-20%. This is mainly due to an overrepresentation of adverse prognostic factors present in elderly AML. As relap...

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Main Authors: Gert J. Ossenkoppele, Jeroen J.W.M. Janssen, Peter C. Huijgens
Format: Article
Language:English
Published: PAGEPress Publications 2013-02-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:http://www.mjhid.org/index.php/mjhid/article/view/415
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author Gert J. Ossenkoppele
Jeroen J.W.M. Janssen
Peter C. Huijgens
author_facet Gert J. Ossenkoppele
Jeroen J.W.M. Janssen
Peter C. Huijgens
author_sort Gert J. Ossenkoppele
collection DOAJ
description Treatment outcome in elderly Acute Myeloid Leukemia (AML) is still very disappointing. Although complete remission rate is around 50-60% the 2 years survival is only in the magnitude of 10-20%. This is mainly due to an overrepresentation of adverse prognostic factors present in elderly AML. As relapses emerge from residual disease present after chemotherapy, intensification of treatment could emerge as a rational strategy. Intensification of chemotherapy by increasing the dose of  anthracyclines or addition of gemtuzumab ozogamycin (Mylotarg) to standard chemotherapy indeed has proved to be of advantage in elderly AML. In younger AML autologous peripheral blood stem cell transplantation (AuPBSCT) as post remission treatment in comparison to intensive consolidation chemotherapy has been investigated in a few randomized studies. AuPBSCT showed reduced relapse rates with low non-relapse mortality rates. In elderly AML intensification by AuPBSCT also have been performed although randomized studies are lacking. Nevertheless, in the previous years various reports have suggested the potential utility of AuHSCT in AML of the elderly with encouraging results, albeit mostly in highly selected patients. Acceptable toxicity and a relatively low rate of transplant-related mortality has been notified. However relapses occurred  which, irrespective of age, still remains the major cause of treatment failure of AuHSCT in AML. In this review we summarize the experience of AuPBSCT in elderly AML.
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spelling doaj-art-7b5c911d4b93416ebb0dddcccadede972025-08-20T02:51:00ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062013-02-0151e2013018e201301810.4084/mjhid.2013.018307AUTOLOGOUS STEM CELL TRANSPLANTATION IN ELDERLY ACUTE MYELOID LEUKEMIAGert J. Ossenkoppele0Jeroen J.W.M. JanssenPeter C. HuijgensGert J. Ossenkoppele, Department of Haematology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands. Tel.: +31 20 4442604; Fax: +31 20 4442601; E-mail: g.ossenkoppele@vumc.nlTreatment outcome in elderly Acute Myeloid Leukemia (AML) is still very disappointing. Although complete remission rate is around 50-60% the 2 years survival is only in the magnitude of 10-20%. This is mainly due to an overrepresentation of adverse prognostic factors present in elderly AML. As relapses emerge from residual disease present after chemotherapy, intensification of treatment could emerge as a rational strategy. Intensification of chemotherapy by increasing the dose of  anthracyclines or addition of gemtuzumab ozogamycin (Mylotarg) to standard chemotherapy indeed has proved to be of advantage in elderly AML. In younger AML autologous peripheral blood stem cell transplantation (AuPBSCT) as post remission treatment in comparison to intensive consolidation chemotherapy has been investigated in a few randomized studies. AuPBSCT showed reduced relapse rates with low non-relapse mortality rates. In elderly AML intensification by AuPBSCT also have been performed although randomized studies are lacking. Nevertheless, in the previous years various reports have suggested the potential utility of AuHSCT in AML of the elderly with encouraging results, albeit mostly in highly selected patients. Acceptable toxicity and a relatively low rate of transplant-related mortality has been notified. However relapses occurred  which, irrespective of age, still remains the major cause of treatment failure of AuHSCT in AML. In this review we summarize the experience of AuPBSCT in elderly AML.http://www.mjhid.org/index.php/mjhid/article/view/415LeukemiaAutologous Hematopoietic stem cell trasplantation, Older people
spellingShingle Gert J. Ossenkoppele
Jeroen J.W.M. Janssen
Peter C. Huijgens
AUTOLOGOUS STEM CELL TRANSPLANTATION IN ELDERLY ACUTE MYELOID LEUKEMIA
Mediterranean Journal of Hematology and Infectious Diseases
Leukemia
Autologous Hematopoietic stem cell trasplantation, Older people
title AUTOLOGOUS STEM CELL TRANSPLANTATION IN ELDERLY ACUTE MYELOID LEUKEMIA
title_full AUTOLOGOUS STEM CELL TRANSPLANTATION IN ELDERLY ACUTE MYELOID LEUKEMIA
title_fullStr AUTOLOGOUS STEM CELL TRANSPLANTATION IN ELDERLY ACUTE MYELOID LEUKEMIA
title_full_unstemmed AUTOLOGOUS STEM CELL TRANSPLANTATION IN ELDERLY ACUTE MYELOID LEUKEMIA
title_short AUTOLOGOUS STEM CELL TRANSPLANTATION IN ELDERLY ACUTE MYELOID LEUKEMIA
title_sort autologous stem cell transplantation in elderly acute myeloid leukemia
topic Leukemia
Autologous Hematopoietic stem cell trasplantation, Older people
url http://www.mjhid.org/index.php/mjhid/article/view/415
work_keys_str_mv AT gertjossenkoppele autologousstemcelltransplantationinelderlyacutemyeloidleukemia
AT jeroenjwmjanssen autologousstemcelltransplantationinelderlyacutemyeloidleukemia
AT peterchuijgens autologousstemcelltransplantationinelderlyacutemyeloidleukemia