The who, how and why: Allogeneic transplant for acute myeloid leukemia in patients older than 60years

Blood Rev. 2017 Nov;31(6):362-369. doi: 10.1016/j.blre.2017.07.002. Epub 2017 Jul 15.


Acute myelogenous leukemia (AML) is primarily a disease of the elderly, and as such, our approach to treatment needs to be tailored to address an aging population. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only potentially curative treatment for intermediate and high risk AML, and until recently, its use had been limited to a younger population and dependent on availability of a donor. Advances in conditioning regimens, supportive care, and the use of alternative donor sources have greatly expanded access to this therapy. In this review, we summarize the challenges and unique biological aspects of treatment with allogeneic stem cell transplantation in this group of patients older than 60years. We also highlight areas of ongoing research including measurement of residual disease prior to and following transplant, post-remission maintenance therapy, and natural killer cell immunotherapy. Finally, we propose future directions for AML treatment in an elderly and aging population.

Keywords: Acute myelogenous leukemia (AML); Allogeneic hematopoietic stem cell transplantation (allo-HSCT); Elderly; Immunotherapy.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cell Transplantation / mortality
  • Humans
  • Immunotherapy / methods
  • Leukemia, Myeloid, Acute / mortality
  • Leukemia, Myeloid, Acute / therapy*
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Secondary Prevention / methods
  • Transplantation, Homologous / methods
  • Transplantation, Homologous / mortality