Age has no influence on mobilization of peripheral blood stem cells in acute myeloid leukemia

Ferrara, Felicetto; Viola, Assunta; Copia, Carolina; Falco, Claudio; D'Elia, Rossella; Tambaro, Francesco Paolo; Correale, Pierpaolo; D’Amico, Maria Rosaria; Vicari, Laura; Palmieri, Salvatore

doi:10.1002/hon.810

Cited by 10 publications

(5 citation statements)

References 36 publications

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“…Overall, 20% of patients received ASCT, mainly causes of exclusion being early relapse and toxicity due to previous treatment. On the contrary, mobilization rate was relatively high, confirming our previous observations that advanced age as well as antecedent MDS does not impair PBSC collection after consolidation therapy in AML [42,43]. Prognosis of autografted patients was significally better than those who did not receive ASCT, but it should be considered that autografted patients are highly selected for best response to induction, consolidation and mobilization as well as for minor non-haematologic toxicity [44].…”

Section: Discussionsupporting

confidence: 84%

Continuous sequential infusion of fludarabine and cytarabine for elderly patients with acute myeloid leukaemia secondary to a previously diagnosed myelodysplastic syndrome

Ferrara

Palmieri

Izzo

et al. 2010

Hematological Oncology

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Acute myeloid leukaemia (AML) secondary to myelodysplastic syndrome (MDS) is characterized by poor prognosis, namely in older patients. The combination of fludarabine (F) with cytarabine (ARA-C) ± G-CSF was proven as effective in patients with poor risk AML. The efficacy and toxicity of a regimen including F + ARA-C as sequential continuous infusion (CI-FLA) in 64 untreated patients aged >60 years, in which AML arose after a previous MDS, was investigated. Median age was 67 years (61-81). In patients achieving CR, an additional course, followed by G-CSF to mobilize CD34+ cells and subsequent autologous stem cell transplantation (ASCT) were programmed. Overall, 43 patients (67%) achieved complete remission (CR). There were 10 induction deaths (16%), while 11 patients (17%) were refractory to induction treatment. Thirty-four patients (79% of remitters) were eligible for the consolidation and 30 were monitorized for the mobilization of CD34+ cells, collection being successful in 20 of them (67%). Median number of CD34+ cells/kg collected was 6.8 × 10E6. Thirteen patients (20% of the whole population) received ASCT. Median disease free survival (DFS) and overall survival (OS) were 10 and 9 months, respectively. Survival at 5 years is projected to 15%. The only parameter significantly related to either DFS duration or OS duration was unfavourable cytogenetics, which did significantly influence also CR achievement. CI-FLA is effective in elderly patients with AML secondary to previously diagnosed MDS. Best results are achievable in the subgroup of patients with diploid karyotype.

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Section: Discussionsupporting

confidence: 84%

Continuous sequential infusion of fludarabine and cytarabine for elderly patients with acute myeloid leukaemia secondary to a previously diagnosed myelodysplastic syndrome

Ferrara

Palmieri

Izzo

et al. 2010

Hematological Oncology

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“…In 2008, the EBMT Lymphoma Working Party showed that intensive chemotherapy followed by ABSCT is feasible in patients over 60 years and that age should not be considered as an exclusion factor [3]. This study confirmed previous data [12][13][14]. One of the factors directly affecting the feasibility of these procedures is the mobilization capacity of CD34+ cells.…”

Section: Discussionsupporting

confidence: 82%

Peripheral blood stem cell collection in elderly patients

Tempescul

Ianotto²,

Hardy³

et al. 2009

Ann Hematol

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Intensive treatments like autologous blood stem cell transplantations are standard consolidation treatments for lymphoma and myeloma in young people. The upper age limit for these procedures is constantly increasing. Instead of studying the impact of aging on harvesting peripheral blood stem cells (PBSC), we performed a retrospective study to explore the feasibility of collecting stem cells from patients older than 65 years and compared the efficacy to harvest in younger patients. During a period of 7 years, we identified 108 patients with myeloma or lymphoma who were older than 65 years who underwent PBSC collection. Only eight patients failed to produce a successful harvest. The majority of patients only needed one apheresis (71%). There was a median number of 5.3× 10 6 CD34+ cells/kg. Our study demonstrated that older patients can also undergo PBSC harvests similar to younger patients.

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“…The influence of age on mobilization of peripheral blood stem cells in AML was investigated by Ferrara et al who performed a retrospective analysis and compared patients below and above 60 years of age 38. The median number of collected CD34+ cells was comparable between the two groups.…”

Section: Mobilization In the Elderlymentioning

confidence: 99%

Autologous Stem Cell Transplantation in Elderly Acute Myeloid Leukemia

Ossenkoppele

Janssen²,

Huijgens³

2013

Mediterr J Hematol Infect Dis

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Treatment outcome in elderly Acute Myeloid Leukemia (AML) is still very disappointing. Although complete remission rate is around 50–60% the 2 years survival is only in the magnitude of 10–20%. This is mainly due to an overrepresentation of adverse prognostic factors present in elderly AML. As relapses emerge from residual disease present after chemotherapy, intensification of treatment could emerge as a rational strategy. Intensification of chemotherapy by increasing the dose of anthracyclines or addition of gemtuzumab ozogamycin (Mylotarg) to standard chemotherapy indeed has proved to be of advantage in elderly AML. In younger AML autologous peripheral blood stem cell transplantation (AuPBSCT) as post remission treatment in comparison to intensive consolidation chemotherapy has been investigated in a few randomized studies. AuPBSCT showed reduced relapse rates with low non-relapse mortality rates. In elderly AML intensification by AuPBSCT also have been performed although randomized studies are lacking. Nevertheless, in the previous years various reports have suggested the potential utility of AuHSCT in AML of the elderly with encouraging results, albeit mostly in highly selected patients. Acceptable toxicity and a relatively low rate of transplant-related mortality has been notified. However relapses occurred which, irrespective of age, still remains the major cause of treatment failure of AuHSCT in AML. In this review we summarize the experience of AuPBSCT in elderly AML.

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Age has no influence on mobilization of peripheral blood stem cells in acute myeloid leukemia

Cited by 10 publications

References 36 publications

Continuous sequential infusion of fludarabine and cytarabine for elderly patients with acute myeloid leukaemia secondary to a previously diagnosed myelodysplastic syndrome

Continuous sequential infusion of fludarabine and cytarabine for elderly patients with acute myeloid leukaemia secondary to a previously diagnosed myelodysplastic syndrome

Peripheral blood stem cell collection in elderly patients

Autologous Stem Cell Transplantation in Elderly Acute Myeloid Leukemia

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