Is outcome of older people with acute myeloid leukemia improving with new therapeutic approaches and stem cell transplantation?
- 22 January 2020
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Review of Hematology
- Vol. 13 (2), 99-108
- https://doi.org/10.1080/17474086.2020.1715207
Abstract
Introduction: The clinical outcome of older patients with acute myeloid leukemia is still poor, especially for those who are unfit to treatments aimed at altering the natural course of the disease. Hypomethylating agents (HMA) offer an important therapeutic opportunity to a consistent number of patients, but long-term results are largely unsatisfactory. Area covered: Recently, a number of new agents have been registered for AML, some of which selectively available for older patient population, with promising results in terms of response rate and survival. Furthermore, the upper age limit for allogeneic stem cell transplantation is constantly increasing, so that this procedure is offered and actually given to an increasing number of older AML patients. A literature review was conducted of the PubMed database for articles published in English as well as for abstracts from most important and recent hematology meetings on AML in older patients. Expert opinion: Appropriate selection among different options on the basis of clinical fitness and molecular findings at diagnosis as well as at relapse would result in improvement of therapeutic results, sparing unnecessary toxicity and optimizing health systems resources.Keywords
This publication has 101 references indexed in Scilit:
- Reduced-intensity conditioning allogeneic hematopoietic-cell transplantation for older patients with acute myeloid leukemiaTherapeutic Advances in Hematology, 2016
- International phase 3 study of azacitidine vs conventional care regimens in older patients with newly diagnosed AML with >30% blastsBlood, 2015
- A randomised comparison of the novel nucleoside analogue sapacitabine with low-dose cytarabine in older patients with acute myeloid leukaemiaLeukemia, 2015
- How I treat the older patient with acute myeloid leukemiaBlood, 2015
- Consensus-based definition of unfitness to intensive and non-intensive chemotherapy in acute myeloid leukemia: a project of SIE, SIES and GITMO group on a new tool for therapy decision makingLeukemia, 2013
- Conventional chemotherapy or hypomethylating agents for older patients with acute myeloid leukaemia?Hematological Oncology, 2013
- Multicenter, Randomized, Open-Label, Phase III Trial of Decitabine Versus Patient Choice, With Physician Advice, of Either Supportive Care or Low-Dose Cytarabine for the Treatment of Older Patients With Newly Diagnosed Acute Myeloid LeukemiaJournal of Clinical Oncology, 2012
- Acute myeloid leukemia in the real world: why population-based registries are neededBlood, 2012
- Treatment of Unfit Patients With Acute Myeloid Leukemia: A Still Open Clinical ChallengeClinical Lymphoma Myeloma and Leukemia, 2011
- Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom?Blood, 2007