Stem cell transplantation in the elderly

The median age of patients with AML is 68 years, with high prevalence of comorbidity, frailty, poor functional status, unfavorable cytogenetics, greater resistance to leukemia-directed treatment, and higher rate of treatment-related toxicities. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative therapy, but, as Professor Stephan Mielke (Karolinska Institutet Stockholm, Sweden) explained in a Basic Science-in-Focus session, in older patients there are many potential barriers. “Considering tumor biology, elderly AML patients have a higher rate of unfavorable genetics. Pushing the limits to higher ages for allo-HSCT requires reducing treatment intensity.”