Hematopoietic stem cell transplantation can be a life-saving treatment for people with blood cancer. But some people are too old or weak to withstand the harsh “conditioning” regimen necessary to kill the diseased cells before transplantation. Some are also more likely to experience serious complications like graft-versus-host disease, or GVHD. This is especially true of older patients or those with underlying health conditions. However, age alone does not provide accurate or reliable enough information about an individual’s ability to withstand transplantation.
At Fred Hutch, researchers have developed risk-assessment tools to better predict survival after hematopoietic cell transplants for patients with acute myeloid leukemia, or AML. The tool helps doctors and patients refine decision-making about the modality and intensity of therapy for AML patients. Our current research aims at assessing the best treatment options to increase quality of life for older and more infirm patients with AML.
Acute myeloid leukemia AML is an aggressive, life-threatening disease whose risk increases with age. However, AML patients aged 60 and survive for shorter periods after diagnosis compared to younger patients due, in part, to less aggressive treatment of their leukemia.
Physicians may not recommend intensive, potentially curative treatment, because they believe their patients may die from the treatment itself. Physicians are even reluctant to offer minimally toxic chemotherapy regimens to their older patients, instead using an arbitrary age cutoff, such as 60 or 70 years, to decide how to treat the AML.
However, age alone is not an accurate measure for risk assessment, since older patients can be healthier than younger patients, depending on other health factors. Organ dysfunctions, for example, are likely more relevant than age in determining how patients will tolerate treatment.
Based on the commonly used Charlson Comorbidity Index, Dr. Mohammed Sorror and his colleagues at Fred Hutch developed the first scoring system, now used worldwide, that reliably predicts the outcome in transplant patients. More recently, they have developed a more refined assessment measure, specifically for AML patients.
The Hematopoietic Cell Transplant Comorbidity Index (HCT-CI)
The AML-Composite Model
Find more information on using our assessment tools to better determine outcomes for older patients with AML.
Find information for your doctor or learn more about our clinical trials to improve outcomes and quality of life for older patients with AML.
Under the mentorship of the Staff Scientist and Project Coordinator, the Clinical Research Intern will assist with tasks throughout the entire research process, including:
Please note that internships are unpaid six month positions requiring at least 10 hours per week.
Contact Jennifer Nyland at jnyland@fredhutch.org for more information.