Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, MMC 480, Minneapolis, MN, 55455, USA.
Best Pract Res Clin Haematol. 2021 Mar;34(1):101243. doi: 10.1016/j.beha.2021.101243. Epub 2021 Jan 12.
Allogeneic transplantation remains the most definitive curative option for patients with acute myeloid leukemia (AML). However, given the median age of diagnosis of AML in the late 60s, patients and clinicians have been reluctant to offer transplant to many in the older population. In this age group, AML presents with higher risk molecular and cytogenetic phenotype and patients' comorbidities, performance status, frailty and life views all impact the decision-making about whether to proceed with transplantation. Recent analyses suggest promising outcomes and thus acknowledgement of chronological age should be tempered with assessments of performance status, frailty, donor availability and careful balancing of a patient's wishes, life goals and understanding of the risks before restricting access of older patients to the curative potential of allotransplantation.
异基因移植仍然是急性髓细胞白血病（AML）患者最有效的根治选择。然而，鉴于 AML 的中位诊断年龄在 60 多岁以后，许多老年患者及其临床医生都不愿意接受移植。在这个年龄组中，AML 具有更高风险的分子和细胞遗传学表型，以及患者的合并症、体能状态、脆弱性和生活观念，这些都影响着是否进行移植的决策。最近的分析表明，该治疗方法有很好的疗效，因此，在限制老年患者获得异体移植根治潜力的机会之前，应该对患者的体能状态、脆弱性、供者可用性进行评估，并在平衡患者的意愿、生活目标和对风险的理解后，再谨慎考虑患者的年龄。
