Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Outcomes in Older Transplant Patients with AML/MDS

Biol Blood Marrow Transplant; ePub 2017 Dec 27; Tsai, et al

Older patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) who underwent haplo/cord reduced intensity transplantation achieved similar outcomes as their counterparts who received HLA-matched unrelated donor cells, according to a study involving 109 individuals. Participants were ≥50 years of age and had AML or high-risk MDS. Between 2007 and 2013, they received either HLA-matched unrelated donor cells (n=68; MUD) or haplo/cord grafts (n=41), followed by reduced intensity conditioning with fludarabine/melphalan and antibody-mediated T-cell depletion. Among the results:

  • 2-year progression-free survival rate was 38% in the group receiving MUD, vs 33% in the haplo/cord transplant contingent.
  • Overall survival rates were 48% in each group.
  • Graft-versus-host disease-free relapse-free rates were 32% and 34%, respectively.
  • Acute grade 2-4 and chronic graft-versus-host-disease rates were similar in both groups.
  • There were no outcome differences by donor type.


Tsai S, Rhodes J, Liu H, et al. Reduced intensity allogeneic transplant for acute myeloid leukemia and myelodysplastic syndrome using combined cd34-selected haploidentical graft and a single umbilical cord unit compared to matched unrelated donor stem cells in older adults. [Published online ahead of print December 27, 2017]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2017.12.794.