scholarly journals Outcomes of Allogeneic Stem Cell Transplantation in Elderly Patients with Acute Myeloid Leukemia: A Systematic Review and Meta-analysis

2016 ◽  
Vol 22 (4) ◽  
pp. 651-657 ◽  
Author(s):  
Armin Rashidi ◽  
Maryam Ebadi ◽  
Graham A. Colditz ◽  
John F. DiPersio
Keyword(s):  
Systematic Review ◽  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Elderly Patients ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Myeloid Leukemia ◽  
Meta Analysis ◽  
Acute Myeloid

scholarly journals Comparative Efficacy and Clinical Outcomes of Haploidentical Stem Cell Transplantation to Other Stem Sources for Treatment in Acute Myeloid Leukemia and Myelodysplastic Syndrome Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 29 ◽  
pp. 096368972090496 ◽  
Author(s):  
Chutima Kunacheewa ◽  
Patompong Ungprasert ◽  
Ployploen Phikulsod ◽  
Surapol Issaragrisil ◽  
Weerapat Owattanapanich
Keyword(s):  
Systematic Review ◽  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Myelodysplastic Syndrome ◽  
Cell Transplantation ◽  
Myeloid Leukemia ◽  
Meta Analysis ◽  
Comparable Efficacy ◽  
Acute Myeloid

The use of allogeneic hematopoietic stem cell transplantation (HSCT) is recommended during the first complete remission of acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS). However, only 30% of these cases have fully matched sibling donors (MSDs). Alternatively, matched unrelated donors (MUDs) and haploidentical (haplo) donors from first-degree relatives increase the access to transplantation, with some reported differences in outcomes. The current systematic review and meta-analysis was conducted with the aim of summarizing the results of those studies to compare the efficacy and toxicity of MSD-HSCT and MUD-HSCT versus haplo-HSCT for patients with AML or MDS. Articles published before September 15, 2018, were individually searched for in two databases (MEDLINE and EMBASE) by two investigators. The effect estimates and 95% confidence intervals (CIs) from each eligible study were combined using the Mantel–Haenszel method. A total of 14 studies met the eligibility criteria and were included in the meta-analysis. The overall survival rates were not significantly different between the groups, with pooled odds ratios of the chance of surviving at the end of the study when comparing haplo-HSCT to MSD-HSCT and comparing haplo-HSCT to MUD-HSCT of 0.85 (95% CI: 0.70 to 1.04; I 2 = 0%) and 1.12 (95% CI: 0.89 to 1.41; I 2 = 33%), respectively. The pooled analyses of other outcomes also showed comparable results, except for the higher grade 2 to 4 acute graft-versus-host disease (GvHD) for patients who received haplo-HSCT than those who received MSD-HSCT, and the better GvHD-free, relapse-free survival and the lower chronic GvHD than the patients in the MUD-HSCT group. These observations suggest that haplo-HSCT is a reasonable alternative with comparable efficacy if MSD-HSCT and MUD-HSCT cannot be performed. Nonetheless, the primary studies included in this meta-analysis were observational in nature, and randomized-controlled trials are still needed to confirm the efficacy of haplo-HSCT.

scholarly journals Allogeneic Stem Cell Transplantation to cure Acute Myeloid Leukemia in elderly patients

1970 ◽  
Vol 1 (1) ◽  
pp. 43-49
Author(s):  
Pritesh Patel ◽  
Santosh Saraf ◽  
Damiano Rondelli
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Elderly Patients ◽  
Cell Transplantation ◽  
Patient Selection ◽  
Allogeneic Stem Cell Transplantation ◽  
Myeloid Leukemia ◽  
Cell Transplant ◽  
Acute Myeloid

Outcomes for elderly patients with acute myeloid leukemia (AML) remain poor with standard therapies. Historically this age group has been excluded from treatment with allogeneic stem cell transplantation (allo-SCT) due to worries of excessive treatment related morbidity and mortality. However, transplantation outcomes have dramatically improved in the last decade due to the widespread use of less ablative conditioning regimens, improved supportive care, and improved patient selection based on prognostic tools such as the hematopoietic cell transplant specific comorbidity index. These have all led to an increasing acceptance of allo-SCT as a potential treatment modality in elderly patients with AML. This review addresses current strategies for patient selection and efficacy data for allo-SCT in elderly patients with AML. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5840 Journal of Advances in Internal Medicine. 2012; 1(1): 43-49

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