Allogeneic hematopoietic stem cell transplantation (HSCT) for high-risk acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS): how can we improve outcomes in the near future?

Substantive advances in the past decade or so have allowed for a wider spectrum of patients to undergo allo-HSCT and have increased its safety, thus broadening the application of this therapy[36]. That said, disease persistence or (more commonly) recurrence remains as primary problems. A combination of “extrinsic” and “intrinsic” methods is now available and ready for additional clinical testing and/or utilization. Fortunately, one can be somewhat optimistic that better results will be achieved, perhaps very soon. However, and as these strategies and techniques are evaluated, it should be realized that some may be too complex and/or expensive for widespread use as the need to reduce costs becomes more pressing.