title: The European LeukemiaNet AML Working Party consensus statement on allogeneic HSCT for patients with AML in remission: an integrated-risk adapted approach.
abstract: Allogeneic haematopoietic stem-cell transplantation (HSCT) is frequently applied as part of the treatment in patients with acute myeloid leukaemia (AML) in their first or subsequent remission. Allogeneic HSCT reduces relapse, but nonrelapse mortality and morbidity might counterbalance this beneficial effect. Here, we review recent studies reporting new disease-specific prognostic markers, in addition to allogeneic-HSCT-related risk factors, which can be assessed at specific time points during treatment. We propose risk assessment as a dynamic process during treatment, incorporating both disease-related and transplant-related factors for the decision to proceed either to allogeneic HSCT or to apply a nontransplant strategy. We suggest that allogeneic HSCT might be favoured if the projected disease-free survival is expected to improve by at least 10% based on an individual's risk assessment. The approach requires initial disease risk assessment, identifying a sibling or unrelated donor soon after diagnosis and the incorporation of time-dependent risk factors, all within the context of an integrated therapeutic management approach.
authors.affiliation: Department of Hematology, Erasmus University Medical Center, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands. j.cornelissen@erasmusmc.nl
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Cornelissen
authors.forename: Alois
authors.initials: A
authors.lastname: Gratwohl
authors.forename: Richard F
authors.initials: RF
authors.lastname: Schlenk
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.forename: Martin
authors.initials: M
authors.lastname: Bornhäuser
authors.forename: Gunnar
authors.initials: G
authors.lastname: Juliusson
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Råcil
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Rowe
authors.forename: Nigel
authors.initials: N
authors.lastname: Russell
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.forename: Bob
authors.initials: B
authors.lastname: Löwenberg
authors.forename: Gerard
authors.initials: G
authors.lastname: Socié
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
authors.forename: Gert J
authors.initials: GJ
authors.lastname: Ossenkoppele
mesh_terms: D032921:Consensus; D019468:Disease Management; D018380:Hematopoietic Stem Cell Transplantation / Q000592:standards*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000209:etiology / Q000628:therapy*; D011379:Prognosis; D012074:Remission Induction; D018570:Risk Assessment