Allogeneic stem cell transplantation in acute myeloid leukemia: a risk-adapted approach.
Allogeneic hematopoietic stem cell transplantation (alloSCT) is nowadays most frequently applied in patients with acute myeloid leukemia (AML). It combines chemoradiotherapy with immunotherapy, also known as the graft-versus-leukemia (GVL) effect. While it effectively reduces the relapse rate in patients, transplanted in remission, non-relapse mortality (NRM) may counterbalance that beneficial effect. As a result, alloSCT is generally associated with a modest gain in overall survival. Therefore, alloSCT may especially be applied in patients with a relatively high risk of relapse and a relatively low risk of NRM. Here, we discuss how recent findings that have identified and validated specific prognostic factors may affect our decision making for which category of AML-patients alloSCT may especially be indicated.
Lodewyck
Tom
T
Department of Hematology, Erasmus University Medical Center-Daniel Den Hoed, Rotterdam, The Netherlands.
Cornelissen
Jan J
JJ
D018572:Disease-Free Survival; D020544:Graft vs Leukemia Effect; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality* / Q000628:therapy*; D012074:Remission Induction; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014184:Transplantation, Homologous