de Lima Marcos, Giralt Sergio
Department of Blood and Marrow Transplantation, M.D. Anderson Cancer Center, Houston, TX 77033, USA.
Semin Hematol. 2006 Apr;43(2):107-17. doi: 10.1053/j.seminhematol.2006.01.004.
Acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) are diseases of the elderly. Allogeneic hematopoietic stem cell transplantation (HSCT) offers the possibility of cure for these malignancies, but until recently its use was restricted to younger patients due to prohibitive treatment-related mortality. Improvements in supportive care and development of reduced-intensity preparative regimens have allowed patients in the sixth, seventh, and to a lesser extent, eighth decade of life to be treated with allogeneic transplantation. Major obstacles to extending this form of treatment to older patients are lack of promptly available donors, graft-versus-host disease (GVHD), delayed immune recovery, and the high prevalence of refractory and relapsed disease intrinsic to the natural history of these myeloid malignancies. Here we review current results of allogeneic blood and marrow transplantation for AML and MDS in the elderly.
急性髓系白血病（AML）和骨髓增生异常综合征（MDS）是老年疾病。异基因造血干细胞移植（HSCT）为治愈这些恶性肿瘤提供了可能，但直到最近，由于与治疗相关的死亡率过高，其应用仅限于年轻患者。支持治疗的改善和低强度预处理方案的发展，使得六七十岁以及在较小程度上八十岁的患者能够接受异基因移植治疗。将这种治疗形式扩展到老年患者的主要障碍包括缺乏及时可用的供体、移植物抗宿主病（GVHD）、免疫恢复延迟以及这些髓系恶性肿瘤自然病程中难治性和复发性疾病的高发生率。在此，我们综述了老年AML和MDS患者异基因血液和骨髓移植的当前结果。
