Transplant Eligible and Ineligible Elderly Patients with AML-A Genomic Approach and Next Generation Questions.
Paul SacksteinAlexis WilliamsRachel A ZemelJennifer A MarksAnne S RenteriaGustavo RiveroPublished in: Biomedicines (2024)
The management of elderly patients diagnosed with acute myelogenous leukemia (AML) is complicated by high relapse risk and comorbidities that often preclude access to allogeneic hematopoietic cellular transplantation (allo-HCT). In recent years, fast-paced FDA drug approval has reshaped the therapeutic landscape, with modest, albeit promising improvement in survival. Still, AML outcomes in elderly patients remain unacceptably unfavorable highlighting the need for better understanding of disease biology and tailored strategies. In this review, we discuss recent modifications suggested by European Leukemia Network 2022 (ELN-2022) risk stratification and review recent aging cell biology advances with the discussion of four AML cases. While an older age, >60 years, does not constitute an absolute contraindication for allo-HCT, the careful patient selection based on a detailed and multidisciplinary risk stratification cannot be overemphasized.
Keyphrases
- acute myeloid leukemia
- bone marrow
- allogeneic hematopoietic stem cell transplantation
- single cell
- community dwelling
- middle aged
- liver failure
- stem cell transplantation
- cell therapy
- free survival
- case report
- drug induced
- cell cycle arrest
- gene expression
- metabolic syndrome
- type diabetes
- smoking cessation
- adverse drug
- intensive care unit
- copy number
- cell death
- high dose
- hepatitis b virus
- hematopoietic stem cell