Open access journal of the Ferrata-Storti Foundation, a non-profit organization
Review Articles

Reduced intensity conditioning allogeneic hematopoietic cell transplantation for adult acute myeloid leukemia in complete remission - a review from the Acute Leukemia Working Party of the EBMT

Section of Hematology and Stem Cell Transplant, Vanderbilt University Medical Center, Nashville, TN, USA
Section of Hematology and Stem Cell Transplant, Vanderbilt University Medical Center, Nashville, TN, USA;Acute Leukemia Working Party of the EBMT, Marseille, France
Programme de Transplantation & Therapie Cellulaire - Centre de Recherche en Cancérologie de Marseille - Institut Paoli Calmettes, Marseille, France
Department of Haematology, Saint Antoine Hospital, Paris, France;INSERM UMR 938, Paris, France;Université Pierre et Marie Curie, Paris, France
Acute Leukemia Working Party of the EBMT, Marseille, France;Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel;EBMT Paris Study Office/CEREST-TC, Paris, France
Department of Haematology, Saint Antoine Hospital, Paris, France;INSERM UMR 938, Paris, France;Université Pierre et Marie Curie, Paris, France;EBMT Paris Study Office/CEREST-TC, Paris, France
Vol. 100 No. 7 (2015): July, 2015 https://doi.org/10.3324/haematol.2015.123331

Abstract

Acute myeloid leukemia is the most common indication for an allogeneic hematopoietic cell transplant. The introduction of reduced intensity conditioning has expanded the recipient pool for transplantation, which has importantly made transplant an option for the more commonly affected older age groups. Reduced intensity conditioning allogeneic transplantation is currently the standard of care for patients with intermediate or high-risk acute myeloid leukemia and is now most often employed in older patients and those with medical comorbidities. Despite being curative for a significant proportion of patients, post-transplant relapse remains a challenge in the reduced intensity conditioning setting. Herein we discuss the studies that demonstrate the feasibility of reduced intensity conditioning allogeneic transplants, compare the outcomes of reduced intensity conditioning versus chemotherapy and conventional myeloablative conditioning regimens, describe the optimal donor and stem cell source, and consider the impact of post-remission consolidation, comorbidities, center experience, and more intensive (reduced toxicity conditioning) regimens on outcomes. Additionally, we discuss the need for further prospective studies to optimize transplant outcomes.

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Article Information

Vol. 100 No. 7 (2015): July, 2015 : Review Articles
 
DOI
https://doi.org/10.3324/haematol.2015.123331
Pubmed
26130513
Pubmed Central
PMC4486220
 
Published
2015-07-01
Published By
Ferrata Storti Foundation, Pavia, Italy
Print ISSN
0390-6078
Online ISSN
1592-8721
 

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ISSN 0390-6078 print | ISSN 1592-8721 online