Haema 2016; 7(2): 203-223
by Stavros Gigantes
Hematology Department and Bone Marrow Transplantation Unit, Evangelismos Hospital, Athens, Greece
Abstract
Allogeneic stem cell transplantation remains the most effective treatment for AML because of the immunologically mediated graft versus leukemia effect. Unfortunately, this beneficial effect is negated by the higher TRM compared with chemotherapy as conventional post remission therapy. However, in recent years there is a substantial improvement in outcomes of transplantation, making it the best post remission therapy for most AML patients. Under the light of the new advances in understanding of molecular biology, the institution of new revised risk factors and the stratification of patient in AML risk groups, any AML patient in CR1 who is eligible for transplantation should be transplanted, except those with favorable risk factors. Of great importance is the use of reduced- intensity regimens, allowing older patients or patients with comorbidities to receive a transplant, either from matched related or matched unrelated donor.