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The outcome of elderly acute myeloid leukemia(AML) patients is poor compared to that of younger patients. Recent reports suggested that allogeneic hematopoietic stem cell transplantation(allo-HSCT)from human leukocyte antigen (HLA)-matched related donors(MRDs)improves the outcome of elderly AML patients if given after successful induction of first complete remission(CR1). However, because their siblings are more likely to be older and in poorer health, less than half of elderly patients have suitable sibling donors. The utility of allo-HSCT from sources other than MRDs (alternative donors)in the management of elderly AML patients in CR1 has not been clarified. While allo-HSCT from HLA-matched unrelated donors(MUDs)shows similar survival compared with allo-HSCT from MRDs, allo-HSCT from partially mismatched donors and umbilical cord blood (UCB)is reported to have worse outcomes than that from HLA-matched donors. The outcome of allo-HSCT for elderly AML patients in CR1 is superior to those given in second CR, but making the decision to perform allo-HSCT in CR1 is difficult for both patients and the attending physicians. The aim of this study was to further investigate the beneficial effects of giving allo-HCST in CR1 compared to chemotherapy alone, and to assess the utility of using transplants from alternative donors, in the management of elderly AML patients. original article

nihon zoketsu saibo ishoku gakkai zasshi

Allogeneic Hematopoietic Stem Cell Transplantation from Sources other than Matched Related Donors in the Management of Elderly Acute Myeloid Leukemia Patients in First Complete Remission