Allogeneic stem cell transplantation in acute myeloid leukemia in first or subsequent remission: weighing prognostic markers predicting relapse and risk factors for non-relapse mortality.
Allogeneic hematopoietic stem cell transplantation (alloSCT) has been established as a powerful treatment modality in acute myeloid leukemia (AML) in first or subsequent remission. Although alloSCT effectively prevents relapse, non-relapse mortality (NRM) associated with the procedure may counterbalance that beneficial effect. As a result, alloSCT generally is restricted to patients with a relatively high risk of relapse and a relatively low risk for NRM. Here, we review recent studies that evaluated specific risk factors that, on the one hand, identified categories of AML patients with a higher risk of relapse and, on the other hand, identified patients with an increased risk for NRM. We discuss how these recent developments may affect our decision-making about whether and when to proceed to alloSCT.
Meijer
Ellen
E
Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Cornelissen
Jan J
JJ
D000367:Age Factors; D014408:Biomarkers, Tumor / Q000032:analysis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D035781:Siblings; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous
D014408:Biomarkers, Tumor