Attempts to Optimizing the Outcomes of Allogeneic Hematopoietic Cell Transplantation in Older Patients (≥60 Years) With Acute Myeloid Leukemia and Myelodysplastic Syndrome

Abstract

Using a non-myeloablative (NMA) regimen [Fludarabine 125 mg/m2 and total body irradiation (TBI) 200cGY], we previously reported the feasibility of allogeneic hematopoietic cell transplantation (HCT) in older patients (n = 24) with AML/MDS using matched sibling donors (MSD) (Gupta et al, 2005, BBMT). GvHD prophylaxis was with Cyclosporine (CsA) (42 days) and Mycophenolate (MMF) for (30 days); CsA was tapered at 42 days in the absence of GvHD. While survival was reasonable; 2 main issues were identified: early relapse and severe chronic GvHD in some patients.