Allogeneic hematopoietic stem cell transplantation in elderly patients with AML and MDS: navigating risks and optimizing outcomes.

The growing burden of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) among aging populations underscores the critical need for tailored treatment strategies for elderly patients. While allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only potentially curative option for eligible patients, its application in older adults is fraught with significant challenges. This review explores recent advancements in optimizing allo-HSCT for elderly patients with AML and MDS. Key considerations include assessing patient fitness, predicting transplant outcomes, refining conditioning regimens, and designing personalized treatment strategies. Optimizing the comprehensive management of elderly patients across the pre-transplant, transplant, and post-transplant phases is expected to broaden access to allo-HSCT and enhance its curative potential.