Allogeneic hematopoietic cell transplantation for older patients Review
| Authors: | Lin, R. J.; Artz, A. S. |
| Review Title: | Allogeneic hematopoietic cell transplantation for older patients |
| Abstract: | Hematologic malignances are more common and often higher risk in older patients. Allogeneic hematopoietic cell transplantation (alloHCT) best enables long-term disease control for patients with poor risk or relapsed/refractory hematologic malignancies such as acute myeloid leukemia, myelodysplastic syndromes, or myelofibrosis. Rates of alloHCT among older patients, while still relatively low compared with younger patients, have risen sharply over the past decade. Accumulating evidence supports alloHCT for patients ≥60 years of age relative to non-HCT therapies based on improved overall and disease-free survival. However, a significant proportion of older adults have limitations characterized by geriatric assessment. A systematic process to evaluate and optimize older patients may improve decision making, transplant outcomes, and alloHCT access. We present case-based studies to illustrate a stepwise and rational approach to proper older patient evaluation, pretransplant optimization, and posttransplant care with attention to important geriatric issues and quality of life. © 2021 American Society of Hematology. All rights reserved. |
| Keywords: | clinical article; human tissue; aged; myelofibrosis; overall survival; cancer recurrence; case report; adjuvant therapy; cancer patient; disease free survival; cytarabine; outcome assessment; antineoplastic agent; quality of life; breast cancer; haloperidol; delirium; cyclophosphamide; high risk patient; febrile neutropenia; patient care; myelodysplastic syndrome; bone marrow biopsy; clinical evaluation; daunorubicin; graft versus host reaction; allogeneic hematopoietic stem cell transplantation; aging; patient decision making; bacteremia; disease control; leukemia relapse; cytopenia; azacitidine; geriatric assessment; leukemia remission; acute myeloid leukemia; human; male; female; article; venetoclax |
| Journal Title: | Hematology-American Society of Hematology Education Program |
| Volume: | 2021 |
| Issue: | 1 |
| ISSN: | 1520-4391 |
| Publisher: | American Society of Hematology |
| Date Published: | 2021-12-10 |
| Start Page: | 254 |
| End Page: | 263 |
| Language: | English |
| DOI: | 10.1182/hematology.2021000257 |
| PUBMED: | 34889392 |
| PROVIDER: | scopus |
| PMCID: | PMC8791130 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 February 2022 -- Source: Scopus |
