Place of HSCT in treatment of childhood AML.

This short review focuses on the role of hematopoietic SCT (HSCT) in childhood AML. In first CR (CR1), some studies demonstrate superiority of allogeneic HSCT with HLA identical sibling donors over the continuation of chemotherapy and others did not. The studies differ in regard to the included risk categories of patients and the outcome niveau of the chemotherapy arm. The BFM98 study found no benefit in having a donor, in particular in terms of overall survival. Autologous HSCT in CR1 is not superior in any of the reviewed trials over the continuation of chemotherapy. In second CR, evidence for the function of allogeneic HSCT is small. However, published data and evidence-based reports recommend an unrelated or related transplantation in the situation of a renewed remission. Data on haploidentical HSCT and on cord blood HSCT are still lacking in the case of AML. Combined studies of larger study groups are warranted to broaden the data basis for rational decision.