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Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia in First Complete Remission: Are We Closer to Knowing Who Needs It?

  • ACUTE LEUKEMIAS (F RAVANDI, SECTION EDITOR)
  • Published:
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Abstract

Acute myeloid leukemia (AML) is a very heterogeneous disease. Prognosis is related not only to intrinsic characteristics such as cytogenetics and molecular markers, but also the patient’s ability to tolerate therapy, and treatment response. Allogeneic stem cell transplantation (allo-HCT) has been traditionally indicated for poor-risk disease in first complete remission (CR1) or for treatment of relapsed or refractory AML. ‘Poor-risk’ disease is now better defined due to genetic subtyping, particularly in chromosomally normal AML. In addition, the presence of comorbid conditions should be included in the decision-making process. Improvements in supportive care and the use of modern conditioning regimens have been associated with improved outcomes, mostly due to a reduction in treatment-related mortality. Therefore, a significant proportion of patients with AML-CR1 can potentially benefit from allo-HCT. We give general guidelines on how to incorporate cytogenetic and molecular risk factors, donor selection, and patient characteristics in order to determine when allo-HCT should be indicated in CR1.

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Conflict of Interest

Dr. Lazaros Lekakis, Dr. Brenda Cooper, and Dr. Marcos de Lima each declare no potential conflicts of interest relevant to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Sylvester Cancer Center, University of Miami, Miami, FL, USA

    Lazaros J. Lekakis

  2. University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH, USA

    Brenda W. Cooper & Marcos G. de Lima

  3. University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA

    Marcos G. de Lima

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  1. Lazaros J. Lekakis
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  2. Brenda W. Cooper
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  3. Marcos G. de Lima
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Correspondence to Marcos G. de Lima.

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Lekakis, L.J., Cooper, B.W. & de Lima, M.G. Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia in First Complete Remission: Are We Closer to Knowing Who Needs It?. Curr Hematol Malig Rep 9, 128–137 (2014). https://doi.org/10.1007/s11899-014-0207-4

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  • DOI: https://doi.org/10.1007/s11899-014-0207-4

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