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For older patients with acute myeloid leukemia (AML) undergoing allogeneic hematopoietic cell transplantation (allo-HCT), posttransplant outcomes have improved over time, according to a study published online March 22 in Clinical Cancer Research.

Ali Bazarbachi, Ph.D., M.P.H., from the American University of Beirut Medical Center in Lebanon, and colleagues identified 7,215 patients (ages 65 years and older) with AML, allografted between 2000 and 2021, in first complete remission, second or subsequent remission, or with active disease (64, 14, and 22 percent, respectively) to examine changes over time in transplant characteristics and outcomes. Patients were followed for a median of 40 months.

The researchers found that over the three time periods (2000 to 2009, 2010 to 2014, and 2015 to 2021), the three-year cumulative relapse incidence decreased gradually and significantly from 37 to 31 to 30 percent; nonrelapse mortality decreased from 31 to 31 to 27 percent. There was gradual and significant improvement seen in three-year leukemia-free survival, from 32 to 38 to 44 percent, and in overall survival, from 37 to 42 to 49 percent. After 2015, significant improvement was noted in relapse incidence, leukemia-free survival, and overall survival in a multivariable analysis, while no significant impact was seen in nonrelapse mortality. The improvement was regardless of disease status at transplant.

“These large-scale, real-world data can serve as a benchmark for future studies in this setting and indicate that the opportunity for transplant for the elderly should be mandatory and no longer an option,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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