Transplant Eligible and Ineligible Elderly Patients with AML—A Genomic Approach and Next Generation Questions

Paul Sackstein; Alexis Williams; Rachel Zemel; Jennifer A. Marks; Anne S. Renteria; Gustavo Rivero

doi:10.3390/biomedicines12050975

Transplant Eligible and Ineligible Elderly Patients with AML—A Genomic Approach and Next Generation Questions

Paul Sackstein, Alexis Williams, Rachel Zemel, Jennifer A. Marks, Anne S. Renteria, Gustavo Rivero

Research output: Contribution to journal › Review article › peer-review

Abstract

The management of elderly patients diagnosed with acute myelogenous leukemia (AML) is complicated by high relapse risk and comorbidities that often preclude access to allogeneic hematopoietic cellular transplantation (allo-HCT). In recent years, fast-paced FDA drug approval has reshaped the therapeutic landscape, with modest, albeit promising improvement in survival. Still, AML outcomes in elderly patients remain unacceptably unfavorable highlighting the need for better understanding of disease biology and tailored strategies. In this review, we discuss recent modifications suggested by European Leukemia Network 2022 (ELN-2022) risk stratification and review recent aging cell biology advances with the discussion of four AML cases. While an older age, >60 years, does not constitute an absolute contraindication for allo-HCT, the careful patient selection based on a detailed and multidisciplinary risk stratification cannot be overemphasized.

Original language	English
Article number	975
Journal	Biomedicines
Volume	12
Issue number	5
DOIs	https://doi.org/10.3390/biomedicines12050975
State	Published - May 2024
Externally published	Yes

Keywords

acute myelogenous leukemia
allogeneic HCT
elderly
pathogenic variants
relapse
remission induction

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10.3390/biomedicines12050975

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title = "Transplant Eligible and Ineligible Elderly Patients with AML—A Genomic Approach and Next Generation Questions",

abstract = "The management of elderly patients diagnosed with acute myelogenous leukemia (AML) is complicated by high relapse risk and comorbidities that often preclude access to allogeneic hematopoietic cellular transplantation (allo-HCT). In recent years, fast-paced FDA drug approval has reshaped the therapeutic landscape, with modest, albeit promising improvement in survival. Still, AML outcomes in elderly patients remain unacceptably unfavorable highlighting the need for better understanding of disease biology and tailored strategies. In this review, we discuss recent modifications suggested by European Leukemia Network 2022 (ELN-2022) risk stratification and review recent aging cell biology advances with the discussion of four AML cases. While an older age, >60 years, does not constitute an absolute contraindication for allo-HCT, the careful patient selection based on a detailed and multidisciplinary risk stratification cannot be overemphasized.",

keywords = "acute myelogenous leukemia, allogeneic HCT, elderly, pathogenic variants, relapse, remission induction",

author = "Paul Sackstein and Alexis Williams and Rachel Zemel and Marks, {Jennifer A.} and Renteria, {Anne S.} and Gustavo Rivero",

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T1 - Transplant Eligible and Ineligible Elderly Patients with AML—A Genomic Approach and Next Generation Questions

AU - Sackstein, Paul

AU - Williams, Alexis

AU - Zemel, Rachel

AU - Marks, Jennifer A.

AU - Renteria, Anne S.

AU - Rivero, Gustavo

PY - 2024/5

Y1 - 2024/5

N2 - The management of elderly patients diagnosed with acute myelogenous leukemia (AML) is complicated by high relapse risk and comorbidities that often preclude access to allogeneic hematopoietic cellular transplantation (allo-HCT). In recent years, fast-paced FDA drug approval has reshaped the therapeutic landscape, with modest, albeit promising improvement in survival. Still, AML outcomes in elderly patients remain unacceptably unfavorable highlighting the need for better understanding of disease biology and tailored strategies. In this review, we discuss recent modifications suggested by European Leukemia Network 2022 (ELN-2022) risk stratification and review recent aging cell biology advances with the discussion of four AML cases. While an older age, >60 years, does not constitute an absolute contraindication for allo-HCT, the careful patient selection based on a detailed and multidisciplinary risk stratification cannot be overemphasized.

AB - The management of elderly patients diagnosed with acute myelogenous leukemia (AML) is complicated by high relapse risk and comorbidities that often preclude access to allogeneic hematopoietic cellular transplantation (allo-HCT). In recent years, fast-paced FDA drug approval has reshaped the therapeutic landscape, with modest, albeit promising improvement in survival. Still, AML outcomes in elderly patients remain unacceptably unfavorable highlighting the need for better understanding of disease biology and tailored strategies. In this review, we discuss recent modifications suggested by European Leukemia Network 2022 (ELN-2022) risk stratification and review recent aging cell biology advances with the discussion of four AML cases. While an older age, >60 years, does not constitute an absolute contraindication for allo-HCT, the careful patient selection based on a detailed and multidisciplinary risk stratification cannot be overemphasized.

KW - acute myelogenous leukemia

KW - allogeneic HCT

KW - elderly

KW - pathogenic variants

KW - relapse

KW - remission induction

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U2 - 10.3390/biomedicines12050975

DO - 10.3390/biomedicines12050975

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JO - Biomedicines

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ER -

Transplant Eligible and Ineligible Elderly Patients with AML—A Genomic Approach and Next Generation Questions

Abstract

Keywords

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