Impact of age on outcomes of allogeneic hematopoietic stem cell transplantation with reduced intensity conditioning in elderly patients with acute myeloid leukemia |
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| Authors: | Jun Aoki Heiwa Kanamori Masatsugu Tanaka Satoshi Yamasaki Takahiro Fukuda Hiroyasu Ogawa Koji Iwato Kazuteru Ohashi Hirokazu Okumura Makoto Onizuka Yoshitomo Maesako Takanori Teshima Naoki Kobayashi Yasuo Morishima Makoto Hirokawa Yoshiko Atsuta Shingo Yano Akiyoshi Takami |
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| Affiliation: | 1. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan;2. Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan;3. Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan;4. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan;5. Department of Hematology, Hiroshima Red Cross Hospital and Atomic‐Bomb Survivors Hospital, Hiroshima, Japan;6. Department of Hematology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan;7. Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan;8. Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan;9. Department of Hematology, Tenri Hospital, Tenri, Japan;10. Department of Hematology, Hokkaido University Hospital, Sapporo, Japan;11. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan;12. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Aichi, Japan;13. Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan;14. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan;15. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan;16. Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan;17. Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan |
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| Abstract: | Previous studies have repeatedly reported that increasing age is a significant risk factor for worse outcomes after allogeneic hematopoietic stem cell transplantation (allo‐HSCT) among patients with acute myeloid leukemia (AML). However, more recent studies reported conflicting results regarding the association between age and outcomes in elderly patients. Therefore, we conducted a large‐scale, nationwide retrospective study to examine the impact of age on outcomes of allo‐HSCT with reduced intensity conditioning (RIC) for AML patients who were older than 50 years. Of the 757 patients, 89 patients (11.8%) were 50–54, 249 patients (32.9%) were 55–59, 301 patients (39.8%) were 60–64 and 118 patients (15.6%) were ≥65 years old. The 3‐year overall survival (OS) (47.8, 45.2, 37.9, and 36.6% for patients aged 50–54, 55–59, 60–64, and ≥65 years, respectively, P = 0.24) and nonrelapse mortality (NRM) (24.0, 22.8, 29.2, and 27.6% for patients aged 50–54, 55–59, 60–64, and ≥65 years, respectively, P = 0.49) were not significantly different among the four age groups. Multivariate analysis revealed that increased age had no significant effect on OS or NRM after adjusting for covariates. These results suggested that advanced patient age is not a contraindication for RIC allo‐HSCT in elderly AML patients. Am. J. Hematol. 91:302–307, 2016. © 2015 Wiley Periodicals, Inc. |
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