How good is allogeneic transplantation for high-risk patients with AML?

Patients with acute myeloid leukemia (AML) may differ significantly in their response to therapy and long-term outcome. A number of risk factors have been identified that characterize patients at diagnosis as well as during their clinical course. At diagnosis these parameters include age, cytogenetic configuration, hemopoietic elements, and a previous history of myelodysplasia or cytoreductive therapy for a preexisting malignancy. They are complemented by the response to induction therapy and subsequent treatments as well as by the duration of response. More recently, gene expression profiling of leukemic cells has added a new dimension to simultaneously assess biological risk factors that may ultimately lead to individualization of therapy. This presentation will review data to address the question of whether or not allogeneic transplants are effective in the management of patients with AML presenting with adverse cytogenetics and older age, showing a poor response to induction therapy, and relapsing after achieving a remission.