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Allogene Stammzelltransplantation bei älteren komorbiden Patienten

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Zusammenfassung

Die meisten Patienten mit malignen hämatologischen Systemerkrankungen sind bei Diagnosestellung über 65 Jahre alt. Bei Hochrisikoerkrankungen ist die allogene hämatopoetische Zelltransplantation (HZT) die einzige Therapieoption, die ein längeres Überleben der Patienten ermöglichen kann. In den zurückliegenden Jahren konnten durch die Etablierung dosisreduzierter Konditionierungsregime sowie durch eine optimierte Supportivtherapie auch für ältere Patienten Therapieergebnisse bei allogenen HZT erreicht werden, die denen bei jüngeren Patienten vergleichbar sind. So können heute Patienten bis hinein in die achte Lebensdekade erfolgreich transplantiert werden. Für die Frage der Transplantierbarkeit älterer Patienten ist weniger das kalendarische Lebensalter, sondern vielmehr das Vorhandensein von Komorbidität als Risikofaktor entscheidend.

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Literatur

  • Aoki J, Kanamori H, Tanaka M et al (2016) Impact of age on outcomes of allogeneic hematopoietic stem cell transplantation with reduced intensity conditioning in elderly patients with acute myeloid leukemia. Am J Hematol 91:302–307

    Article  PubMed  Google Scholar 

  • Armand P, Kim HT, Logan BR et al (2014) Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation. Blood 123:3664–3671

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bastida JM, Cabrero M, Lopez-Godino O et al (2015) Influence of donor age in allogeneic stem cell transplant outcome in acute myeloid leukemia and myelodisplastic syndrome. Leuk Res 39:828–834

    Article  CAS  PubMed  Google Scholar 

  • Beelen DW (2015) Jahresbericht DRST

    Google Scholar 

  • Blaise D, Furst S, Crocchiolo R et al (2016) Haploidentical T cell-replete transplantation with post-transplantation cyclophosphamide for patients in or above the sixth decade of age compared with allogeneic hematopoietic stem cell transplantation from an human leukocyte antigen-matched related or unrelated donor. Biol Blood Marrow Transplant 22:119–124

    Article  PubMed  Google Scholar 

  • Burnett A, Wetzler M, Lowenberg B (2011) Therapeutic advances in acute myeloid leukemia. J Clin Oncol 29:487–494

    Article  PubMed  Google Scholar 

  • Brunner AM, Kim HT, Coughlin E, Alyea EP 3rd, Armand P, Ballen KK, Cutler C, Dey BR, Glotzbecker B, Koreth J, McAfee SL, Spitzer TR, Soiffer RJ, Antin JH, Ho VT, Chen YB (2013) Outcomes in patients age 70 or older undergoing allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Biol Blood Marrow Transplant 19(9):1374–1380

    Article  PubMed  Google Scholar 

  • Clift RA, Buckner CD, Appelbaum FR et al (1990) Allogeneic marrow transplantation in patients with acute myeloid leukemia in first remission: a randomized trial of two irradiation regimens. Blood 76:1867–1871

    CAS  PubMed  Google Scholar 

  • Devine SM, Owzar K, Blum W et al (2015) Phase II study of allogeneic transplantation for older patients with acute myeloid leukemia in first complete remission using a reduced-intensity conditioning regimen: results from cancer and leukemia group B 100103 (alliance for clinical trials in oncology)/blood and marrow transplant clinical trial network 0502. J Clin Oncol 33:4167–4175

    Article  PubMed  PubMed Central  Google Scholar 

  • Estey E, De Lima M, Tibes R et al (2007) Prospective feasibility analysis of reduced-intensity conditioning (RIC) regimens for hematopoietic stem cell transplantation (HSCT) in elderly patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS). Blood 109:1395–1400

    Article  CAS  PubMed  Google Scholar 

  • Extermann M, Aapro M, Bernabei R et al (2005) Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the international society of geriatric oncology (SIOG). Crit Rev Oncol Hematol 55:241–252

    Article  PubMed  Google Scholar 

  • Farag SS, Maharry K, Zhang MJ et al (2011) Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60–70 years with acute myelogenous leukemia in first remission. Biol Blood Marrow Transplant 17:1796–1803

    Article  PubMed  Google Scholar 

  • Giralt S, Thall PF, Khouri I et al (2001) Melphalan and purine analog-containing preparative regimens: reduced-intensity conditioning for patients with hematologic malignancies undergoing allogeneic progenitor cell transplantation. Blood 97:631–637

    Article  CAS  PubMed  Google Scholar 

  • Juliusson G, Lazarevic V, Horstedt AS et al (2012) Acute myeloid leukemia in the real world: why population-based registries are needed. Blood 119:3890–3899

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kayser S, Dohner K, Krauter J et al (2011) The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. Blood 117:2137–2145

    Article  CAS  PubMed  Google Scholar 

  • Kollman C, Howe CW, Anasetti C et al (2001) Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age. Blood 98:2043–2051

    Article  CAS  PubMed  Google Scholar 

  • Krauter J, Wagner K, Stadler M et al (2011) Prognostic factors in allo-SCT of elderly patients with AML. Bone Marrow Transplant 46:545–551

    Article  CAS  PubMed  Google Scholar 

  • Kroger N, Zabelina T, De Wreede L et al (2013) Allogeneic stem cell transplantation for older advanced MDS patients: improved survival with young unrelated donor in comparison with HLA-identical siblings. Leukemia 27:604–609

    Article  CAS  PubMed  Google Scholar 

  • Luznik L, O’donnell PV, Symons HJ et al (2008) HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant 14:641–650

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mcsweeney PA, Niederwieser D, Shizuru JA et al (2001) Hematopoietic cell transplantation in older patients with hematologic malignancies: replacing high-dose cytotoxic therapy with graft-versus-tumor effects. Blood 97:3390–3400

    Article  CAS  PubMed  Google Scholar 

  • Medeiros BC, Satram-Hoang S, Hurst D et al (2015) Big data analysis of treatment patterns and outcomes among elderly acute myeloid leukemia patients in the United States. Ann Hematol 94:1127–1138

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Michelis FV, Messner HA, Atenafu EG et al (2014) Benefit of allogeneic transplantation in patients age >/= 60 years with acute myeloid leukemia is limited to those in first complete remission at time of transplant. Biol Blood Marrow Transplant 20:474–479

    Article  PubMed  Google Scholar 

  • Muffly LS, Kocherginsky M, Stock W et al (2014) Geriatric assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients. Haematologica 99:1373–1379

    Article  PubMed  PubMed Central  Google Scholar 

  • Passweg JR, Baldomero H, Bader P et al (2016) Hematopoietic stem cell transplantation in Europe 2014: more than 40,000 transplants annually. Bone Marrow Transplant 51:786–792

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pohlen M, Groth C, Sauer T et al (2016) Outcome of allogeneic stem cell transplantation for AML and myelodysplastic syndrome in elderly patients (60 years). Bone Marrow Transplant 51:1441–1448

    Article  CAS  PubMed  Google Scholar 

  • Raiola AM, Dominietto A, Ghiso A et al (2013) Unmanipulated haploidentical bone marrow transplantation and posttransplantation cyclophosphamide for hematologic malignancies after myeloablative conditioning. Biol Blood Marrow Transplant 19:117–122

    Article  CAS  PubMed  Google Scholar 

  • Roman E, Smith A, Appleton S et al (2016) Myeloid malignancies in the real-world: occurrence, progression and survival in the UK’s population-based Haematological Malignancy Research Network 2004–15. Cancer Epidemiol 42:186–198

    Article  PubMed  PubMed Central  Google Scholar 

  • Rowe JM, Lazarus HM, Carella AM (2000) Hematopoietic stem cell transplantation in older adults. In: Rowe JM, Lazarus HM, Carella AM (Hrsg) Handbook of Bone Marrow Transplantation. Martin Dunitz Ltd., London, S 111–137

    Google Scholar 

  • Sandhu KS, Brunstein C, Defor T et al (2016) Umbilical cord blood transplantation outcomes in acute myelogenous leukemia/myelodysplastic syndrome patients aged >/=70 years. Biol Blood Marrow Transplant 22:390–393

    Article  PubMed  Google Scholar 

  • Schmid C, Schleuning M, Schwerdtfeger R et al (2006) Long-term survival in refractory acute myeloid leukemia after sequential treatment with chemotherapy and reduced-intensity conditioning for allogeneic stem cell transplantation. Blood 108:1092–1099

    Article  CAS  PubMed  Google Scholar 

  • Schneidawind D, Federmann B, Buechele C et al (2016) Reduced-intensity conditioning with fludarabine and busulfan for allogeneic hematopoietic cell transplantation in elderly or infirm patients with advanced myeloid malignancies. Ann Hematol 95:115–124

    Article  CAS  PubMed  Google Scholar 

  • Slavin S, Nagler A, Naparstek E et al (1998) Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood 91:756–763

    CAS  PubMed  Google Scholar 

  • Sorror ML, Maris MB, Storb R et al (2005) Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 106:2912–2919

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Stelljes M, Bornhauser M, Kroger M et al (2005) Conditioning with 8-Gy total body irradiation and fludarabine for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia. Blood 106:3314–3321

    Article  CAS  PubMed  Google Scholar 

  • Tutschka PJ, Copelan EA, Klein JP (1987) Bone marrow transplantation for leukemia following a new busulfan and cyclophosphamide regimen. Blood 70:1382–1388

    CAS  PubMed  Google Scholar 

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Correspondence to Daniela Heidenreich .

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Heidenreich, D., Klein, S. (2016). Allogene Stammzelltransplantation bei älteren komorbiden Patienten. In: Ebert, M., Härtel, N., Wedding, U. (eds) Geriatrische Onkologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49083-9_9-1

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  • DOI: https://doi.org/10.1007/978-3-662-49083-9_9-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49083-9

  • Online ISBN: 978-3-662-49083-9

  • eBook Packages: Springer Referenz Medizin

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