Acute myeloid leukemia (AML), a cancer that develops in the bone marrow and blood when immature white blood cells called myeloblasts grow uncontrollably, is known for its aggressive pathology. Because of AML’s fast-growing nature, it commonly metastasizes to other parts of the body, such as the liver, brain, and skin.
AML occurs most frequently in older people (average age 68) and remains scarce in individuals under 45. AML patients treated with allogeneic hematopoietic cell transplantation (allo-HCT) receive immune cells from a healthy donor. While allo-HCT can be a highly effective anti-cancer treatment, the complex procedure poses some risks. Thus, a patient’s age and overall health play a factor in choosing this therapy. However, technological advances have reduced risks, and allo-HCT has become an option for more and more patients over recent years.
A recent study in Clinical Cancer Research assessed the safety and associated outcomes of allo-HCT for patients over 65. The researchers identified 7,215 AML patients between 65 and 68 years of age. All patients enrolled in the study received an allogenic transplant between 2000 and 2021. Most (64%) of the patients in the study were in their first remission, while 14% were in a second remission or more. The remaining 22% of the patients had active disease.
At the time of data analysis, the patients had a median follow-up time of 40 months. When considering three time periods (2000–2009, 2010–2014, and 2015–2021), the researchers looked at three-year cumulative relapse incidence (RI), a measure of how many patients exhibited a relapse decrease throughout the study. Initially, the RI reached 37% and subsequently reduced to 31% and 30%. Similarly, non-relapse mortality (NRM), a measure of how many patients died without relapse or progressive disease, decreased from 31% to 27%. Three-year leukemia-free survival (LFS) also improved over time (32%, 38%, and 44%), as did overall survival (37%, 42%, 49%).
Overall, the study reported notable improvements in the outcomes of older AML patients receiving allo-HCT. The authors attributed the changes observed primarily to decreased RI and less to the reduction in NRM.
Sources: Cancer Treat Res, Front Immunol, Clin Cancer Res