How old is too old for a transplant?

Research output: Contribution to journalReview articlepeer-review

Abstract

Allogeneic transplantation remains the most definitive curative option for patients with acute myeloid leukemia (AML). However, given the median age of diagnosis of AML in the late 60s, patients and clinicians have been reluctant to offer transplant to many in the older population. In this age group, AML presents with higher risk molecular and cytogenetic phenotype and patients' comorbidities, performance status, frailty and life views all impact the decision-making about whether to proceed with transplantation. Recent analyses suggest promising outcomes and thus acknowledgement of chronological age should be tempered with assessments of performance status, frailty, donor availability and careful balancing of a patient's wishes, life goals and understanding of the risks before restricting access of older patients to the curative potential of allotransplantation.

Original languageEnglish (US)
Article number101243
JournalBest Practice and Research: Clinical Haematology
Volume34
Issue number1
DOIs
StatePublished - Mar 2021

Bibliographical note

Funding Information:
The author receives research support from Incyte and from FATE Therapeutics, both unrelated to this work. Supported in part by funding from the NIH to the CIBMTR through: U24CA076518 , U24HL138660 and U24CA233032 .

Publisher Copyright:
© 2021 Elsevier Ltd

Keywords

  • Age
  • Allogeneic transplant
  • Frailty
  • Non-relapse mortality

PubMed: MeSH publication types

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

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