Brazilian guidelines on hematopoietic stem cell transplantation in acute myeloid leukemia.
OBJECTIVE
Acute myeloid leukemia (AML) accounts for 90% of all cases of acute leukemia in adults. In Brazil, the mortality from myeloid leukemia is 1.74/100 000 men and 1.37/100 000 women. Our aim was to review and update guidelines of the Brazilian Society of Bone Marrow Transplantation on indications of hematopoietic stem cell transplantation (HSCT) for the treatment AML.


CONCLUSIONS
(i) Allo-HSCT is recommended for high-risk AML (IA); (ii) allo-HSCT is recommended for AML of intermediate risk (IA); (iii) allo-HSCT is recommended for AML relapsed/refractory (C4); (iv) auto-HSCT is recommended for AML after 1 consolidation (C4); (v) auto-HSCT is recommended for AML in CR1 (higher than QT in the Brazilian experience) (C4); (vi) auto-HSCT is accepted for AML M3 in second molecular complete remission (2B); (vii) peripheral blood instead of Bone Marrow HSC for advanced disease (2A); (viii) recommended conditioning protocols: Bu-Cy/Bu-Mel, Bu-Flu, TBI-Cy. In umbilical cord HSCT, consider ATG-based protocols (2A); (ix) allogeneic HSCT for the treatment of AML can be used in patients between 60 and 80 yr with good performance status and the absence of significant comorbidities (C4).
Cellular Therapy Program HCPA, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Lucia
L
Silla
Bone Marrow Transplantation Unit, Hospital Inglês, São Paulo, Brazil.
Frederico
F
Dulley
Bone Marrow Transplantation Unit, Hospital Inglês, São Paulo, Brazil.
Rosaura
R
Saboya
Hematology and Bone Marrow Transplantation Unit, Hospital Albert Einstein e UNIFESP, São Paulo, Brazil.
Fabio
F
Kerbauy
Hematology and Bone Marrow Transplantation Unit, Hospital Araújo Jorge, Goiãnia, Brazil.
Adriano
A
de Moraes Arantes
Cellular Therapy Program HCPA, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Annelise
A
Pezzi
Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Luisa Grave
LG
Gross
Bone Marrow Transplantation Unit, Hospital de Cancer de Barretos, Barretos, Brazil.
Eduardo
E
Paton
Hematology and Bone Marrow Transplantation Unit, Hospital Albert Einstein e UNIFESP, São Paulo, Brazil.
Nelson
N
Hamerschlak
D001938:Brazil; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*
acute myeloid leukemia; bone marrow transplantation; guideline; hematopoietic stem cell transplantation