Referral to and receipt of allogeneic hematopoietic stem cell transplantation in older adults with acute myeloid leukemia.

Autor: Manogna D; Department of Hematology and Oncology, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: dmanogna@tulane.edu., Lipof JJ; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: jodi_lipof@urmc.rochester.edu., Baran AM; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: andrea_baran@urmc.rochester.edu., Said B; Department of Hematology and Oncology, Stony Brook University, Long Island, New York, USA. Electronic address: bassil.said@stonybrookmedicine.edu., Becker MW; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: michael_becker@urmc.rochester.edu., Mendler JH; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: jason_mendler@urmc.rochester.edu., Aljitawi OS; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: omar_aljitawi@urmc.rochester.edu., O'Dwyer KM; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: kristen_odwyer@urmc.rochester.edu., Huselton E; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: eric_huselton@urmc.rochester.edu., Burack R; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: richard_burack@urmc.rochester.edu., Blaney M; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: margaret_blaney@urmc.rochester.edu., Liesveld JL; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: jane_liesveld@urmc.rochester.edu., Loh KP; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center Rochester, New York, USA. Electronic address: kahpoh_loh@urmc.rochester.edu.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2023 Jan; Vol. 14 (1), pp. 101403. Date of Electronic Publication: 2022 Nov 10.
DOI: 10.1016/j.jgo.2022.11.002
Abstrakt: Introduction: Recent data have shown improved outcomes in selected older adults with acute myeloid leukemia (AML) following allogeneic hematopoietic stem cell transplantation (HSCT). Nonetheless, practice patterns for referring and performing HSCT vary. We aimed to evaluate referral, utilization, and reasons for not referring/proceeding to HSCT in older adults with AML.
Materials and Methods: This is a single center retrospective analysis of patients aged ≥60 years diagnosed with AML evaluating rates of HSCT referral and utilization. Fisher's exact test was used to compare rates of referral and utilization across age groups and years of diagnosis.
Results: Median age of the 97 patients was 70 years (range 61-95); 30% (29/97) were referred for HSCT and of these, 69% (20/29) received HSCT. Common documented reasons (can be multiple) for not referring were performance status (n = 21), advanced age (n = 16), patient refusal (n = 15), refractory disease (n = 14), and prohibitive comorbidity (n = 6). Among patients who were referred but did not receive HSCT (n = 9/29), documented reasons for not proceeding with HSCT were refractory disease (n = 5), advanced age (n = 2), and prohibitive comorbidity (n = 2). HSCT referral and utilization rates significantly decreased with age (p < 0.01) but were generally stable over time from 2014 to 2017 (p = 0.40 for referral and p = 0.56 for utilization).
Discussion: Despite improvements in supportive care and HSCT techniques, HSCT referral and utilization rates remained low among older adults with AML but stable over time.
Competing Interests: Conflicts of Interest Dr. Loh has received honoraria from Pfizer, and has served as a consultant to Pfizer and Seattle Genetics. All other authors declare no conflict of interest.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: