HLA-mismatched Microtransplant: Older AML Patients were benefitted


A new study led by 12 centers in China, the U.S., and Spain showed that HLA-mismatched micro-transplant improved complete remission and good overall survival rate among older AML Patients.

Dr. Hui-Sheng Ai from Affiliated Hospital of The Academy of Military Medical Sciences said, “Microtransplant dramatically improved the outcome of older patients with AML. We found that micro-transplant could  significantly improve complete remission rate in older AML patients ( age groups 60 to 85), overall survival of 1-year and 2-year and disease-free survival, especially in patients aged 60 to 75.”

Micro-transplant combined chemotherapy and infusion of HLA-mismatched peripheral blood stem cells benefited small cohorts of older AML patients in clinical studies. In a study published in JAMA Oncology, Dr. Ai and associates examined complete remission rates, leukemia-free survival, overall survival in older patients with newly diagnosed AML who underwent HLA-mismatched micro-transplant among 60-64, 65-69, 70-74, and 75-85 subgroups.

The research team found 74.6% of the overall complete remission rate without significant difference in the four subgroups. AML patients in the age group of 75-85 reported 52% of the overall survival rate at 12 months and 15% at 24 months, whereas, the other age groups reported 78%-88% at 12 months and 34%-67% at 24 months. A high rate of leukemia-free survival and low rate of non-relapse death was found among 60-64 and 65-69 age groups when compared to 70-74 and 75-85 age groups.

“These results are much better than those of traditional chemotherapy, myeloablative, and non-myeloablative transplant. This provides a more safe and effective treatment choice. We are looking forward to seeing the revision of National Comprehensive Cancer Network (NCCN) guidelines for older AML to make micro-transplant benefit more older patients,” said Dr. Ai.

Dr. Ai highlighted that when compared to younger patients, older AML patients could achieve the similar or nearly complete remission rate with proper treatment. Completion of 2 or 3 courses of post-remission consolidation chemotherapy could benefit the older patients with long-term survival.  

“In addition, we suggest that doctors and NCCN guideline makers reduce or abandon decisions like supportive care only or low-dose chemotherapy to older AML patients. These patients also have the privilege and opportunity to get better long-term survival,” added Dr. Ai.