25 March 2024

Survival rates of older patients receiving allogeneic stem cell transplants have significantly improved this century, according to a new study.

Researchers say the findings show that age should not be a factor in deciding whether patients are suitable for transplants for treating acute myeloid leukaemia (AML).

AML has a median age at diagnosis of 68. Changes such as high-resolution human leukocyte antigen typing and new generation anti-infectious agents have made the transplants safer and more popular, according to Professor Ali Bazarbachi.

Bazarbachi led a study of a dataset held by the European Society for Blood and Marrow Transplantation. It included 7,215 patients over the age of 65 treated with allogeneic haematopoietic stem cell transplant (allo-HCT) since 2000.

The researchers analysed outcomes for patients, compared those treated in three time periods: 2000 to 2009, 2010 to 2014, and 2015 to 2021.

The study, reported in Clinical Cancer Research, found that relapse incidence decreased across the three time periods, 37% to 31% to 30%. Mortality also reduced, while 3-year leukaemia-free survival increased from 32% to 38% to 44%.

Rates of graft versus host disease fell from 35% to 31%.

Professor Bazarbachi, from the American University of Beirut, Lebanon, said: “Our study represents one of the largest analyses to date assessing trends over time and predictive factors for outcomes in elderly AML patients after allo-HCT.

“In tandem with the marked increase in elderly patients receiving allo-HCT, we observed an impressive improvement over time in leukaemia-free and overall survival. These data indicate that allo-HCT should no longer be optional but should be mandatory for patients.”


Bazarbachi A, Labopin M, Moukalled N, Kröger N, Rautenberg C, Schetelig J, Jürgen Finke, Blau IW, Blaise D, Stelljes M, Eder M, Platzbecker U, Dreger P, Bethge W, Tischer J, Burns D, Sengeloev H, Brissot E, Giebel S, Nagler A, Ciceri F, and Mohty M (2024) “Improvements in post-transplant outcomes over two decades in older patients with acute myeloid leukemia in the EBMT ALWP study.” Clinical Cancer Research, doi: 10.1158/1078-0432.CCR-23-3673

Link: https://aacrjournals.org/clincancerres/article/doi/10.1158/1078-0432.CCR-23-3673/741856/Improvements-in-Posttransplant-Outcomes-Over-Two

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