Conditioning Regimens for Frail Patients with Acute Leukemia Undergoing Allogeneic Stem Cell Transplant: How to Strike Gently

Authors

Francesco Saraceni^*, , Ilaria Scortechini, Alessandro Fiorentini, Maria Vittoria Dubbini, Giorgia Mancini, Irene Federici, Francesca Romana Colaneri, Antonio Federico Lotito, Selene Guerzoni, Bruna Puglisi, Attilio Olivieri

Hematology and Stem Cell Transplant, Ospedali Riuniti Ancona, Via Conca 71, Ancona, Italy

^*Corresponding author. Email: francesco.saraceni@ospedaliriuniti.marche.it

DOI

10.2991/chi.k.210731.001How to use a DOI?

Keywords

Conditioning regimens; frail patients; acute leukemia; allogeneic stem cell transplant

Abstract

Despite the recent dramatic progress in acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) therapy, allogeneic transplant remains a mainstay of treatment for patients with acute leukemia. The availability of novel compounds and low intensity chemotherapy regimens made it possible for a significant proportion of elderly and comorbid patients with AML or ALL to undergo curative treatment protocols. In addition, the expansion of donor availability and the recent dramatic progress in haploidentical stem cell transplant, allow the identification of an available donor for nearly every patient. Therefore, an increasing number of transplants are currently performed in elderly and frail patients with AML or ALL. However, allo-Hematopoietic stem cell transplant (HSCT) in this delicate setting represents an important challenge, especially regarding the selection of the conditioning protocol. Ideally, conditioning intensity should be reduced as much as possible; however, in patients with acute leukemia relapse remains the major cause of transplant failure. In this article we present modern tools to assess the patient health status before transplant, review the available data on the outcome of frail AML an ALL patients undergoing allo-HSCT, and discuss how preparatory regimens can be optimized in this setting.

Copyright

© 2021 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Francesco Saraceni
AU  - Ilaria Scortechini
AU  - Alessandro Fiorentini
AU  - Maria Vittoria Dubbini
AU  - Giorgia Mancini
AU  - Irene Federici
AU  - Francesca Romana Colaneri
AU  - Antonio Federico Lotito
AU  - Selene Guerzoni
AU  - Bruna Puglisi
AU  - Attilio Olivieri
PY  - 2021
DA  - 2021/08/19
TI  - Conditioning Regimens for Frail Patients with Acute Leukemia Undergoing Allogeneic Stem Cell Transplant: How to Strike Gently
JO  - Clinical Hematology International
SP  - 153
EP  - 160
VL  - 3
IS  - 4
SN  - 2590-0048
UR  - https://doi.org/10.2991/chi.k.210731.001
DO  - 10.2991/chi.k.210731.001
ID  - Saraceni2021
ER  -