The ability of older leukemia patients to have a transplant requires a combination of the patient’s age, physical condition, comorbidities, and the risk level of the disease itself.
Current national and international guidelines recommend that reduced-dose or non-cleared marrow pretreatment allogeneic transplantation be considered for elderly leukemia patients aged 60 to 70 years with risk factors for poor prognosis, who are in good general condition and have essentially normal function of their vital organs, and in the presence of a suitable donor.
In addition, in developed countries, successful transplantation has been reported in elderly leukemia patients aged 70 to 75 years, provided that the elderly patients are in good physical condition, the hardware facilities and supportive care in the transplantation ward are excellent, and complications such as infection can be effectively controlled.
But patients over 70 years of age in China are generally less tolerant and have more complications such as infection after transplantation, and are essentially lost to transplantation.
For elderly patients with acute myeloblastic leukemia (AML) who cannot tolerate conventional allogeneic transplantation, cord blood transplantation or cord blood transfusion may also be considered. Cord blood transplantation is often not truly viable for adults because of the small number of stem cells, but it also has some anti-tumor effects through immunomodulatory effects such as those produced by the infusion of cord blood.