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Bridging Strategies to Allogeneic Transplant for Older AML Patients

Department of Medicine III, Hematology and Oncology, Technische Universität München, 80333 Munich, Germany
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Judith Hecker and Isabella Miller shared first authorship.
Cancers 2018, 10(7), 232; https://doi.org/10.3390/cancers10070232
Received: 7 May 2018 / Revised: 27 June 2018 / Accepted: 6 July 2018 / Published: 11 July 2018
(This article belongs to the Special Issue Treatment of Older Adults with Acute Myeloid Leukemia)
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Abstract

Treatment options for older patients with intermediate or high-risk acute myeloid leukemia (AML) remain unsatisfactory. Allogeneic stem cell transplantation, the treatment of choice for the majority of younger AML patients, has been hampered in elderly patients by higher treatment related mortality, comorbidities and lack of a suitable donor. With the higher availability of suitable donors as well as of reduced intensity conditioning regimens, novel low intensity treatments prior to transplantation and optimized supportive care, the number of older AML patients being successfully transplanted is steadily increasing. Against this background, we review current treatment strategies for older AML patients planned for allogeneic stem cell transplantation based on clinical trial data, discussing differences between approaches with advantages and pitfalls of each. We summarize pre-treatment considerations that need to be taken into account in this highly heterogeneous older population. Finally, we offer an outlook on areas of ongoing clinical research, including novel immunotherapeutic approaches that may improve access to curative therapies for a larger number of older AML patients. View Full-Text
Keywords: elderly AML; bridging strategies; allogeneic stem cell transplant; chemotherapy; hypomethylating agents elderly AML; bridging strategies; allogeneic stem cell transplant; chemotherapy; hypomethylating agents
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Hecker, J.; Miller, I.; Götze, K.S.; Verbeek, M. Bridging Strategies to Allogeneic Transplant for Older AML Patients. Cancers 2018, 10, 232.

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