title: Should persons with acute myeloid leukemia have a transplant in first remission?
abstract: Despite more than 40 years of extensive study, it remains uncertain which individuals, if any, with acute myelogenous leukemia (AML) in first remission should receive a blood cell or bone marrow transplant versus post-remission chemotherapy (or both). Nevertheless, there is a recent trend toward recommending more transplants in this setting. We consider four myths underlying this recommendation: (1) only individuals achieving second remission benefit from a transplant; (2) there is no effective therapy for relapse other than an allotransplant; (3) we can accurately predict which individuals with AML in first remission need a transplant; and (4) detection of minimal residual disease in first remission will resolve this controversy. We discuss these misconceptions and suggest approaches to resolve this issue.
authors.affiliation: Haematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK.
authors.forename: R P
authors.initials: RP
authors.lastname: Gale
authors.affiliation: Cancer Research Foundation of New York, Chappaqua, NY, USA.
authors.forename: P H
authors.initials: PH
authors.lastname: Wiernik
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Lazarus
mesh_terms: D000970:Antineoplastic Agents / Q000737:chemistry; D016026:Bone Marrow Transplantation / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D018365:Neoplasm, Residual; D012008:Recurrence; D012074:Remission Induction; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
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