Alexandra Gomez-Arteaga1, Boglarka Gyurkocza1,2. 1. Department of Medicine, Memorial Sloan Kettering Cancer Center. 2. Department of Medicine, Weill Cornell Medical College of Cornell University, New York, New York, USA.
Abstract
PURPOSE OF REVIEW: Allogeneic hematopoietic cell transplantation (HCT), with associated graft-versus-leukemia effects, remains the best postremission strategy for patients with intermediate or high-risk acute myeloid leukemia (AML), with a curative potential. Here, we highlight recent advances in allogeneic HCT that broadened access, refined prognostication, and improved outcomes of AML patients undergoing this procedure. RECENT FINDINGS: Eligibility for allogeneic HCT continued to expand to AML patients older than 60 years, as well as to patients lacking human leukocyte antigen (HLA)-matched donors with the advent of alternative donor sources, such as umbilical cord blood and HLA-haploidentical transplantation. Molecular profiling of AML has redefined prognostication for patients in specific AML genomic subgroups undergoing allogeneic HCT and has served as a new strategy for measuring minimal residual disease before and after allogeneic HCT. Using high intensity conditioning regimens has emerged as a potential strategy to reduce risk of relapse and improve overall survival, especially in patients with minimal residual disease prior to allogeneic HCT. SUMMARY: As access to allogeneic HCT continues to improve, also, with more refined prognostic strategies, the field continues to move to optimize transplantation approaches by decreasing the risk of relapse and minimizing transplant-related complications.
PURPOSE OF REVIEW: Allogeneic hematopoietic cell transplantation (HCT), with associated graft-versus-leukemia effects, remains the best postremission strategy for patients with intermediate or high-risk acute myeloid leukemia (AML), with a curative potential. Here, we highlight recent advances in allogeneic HCT that broadened access, refined prognostication, and improved outcomes of AMLpatients undergoing this procedure. RECENT FINDINGS: Eligibility for allogeneic HCT continued to expand to AMLpatients older than 60 years, as well as to patients lacking human leukocyte antigen (HLA)-matched donors with the advent of alternative donor sources, such as umbilical cord blood and HLA-haploidentical transplantation. Molecular profiling of AML has redefined prognostication for patients in specific AML genomic subgroups undergoing allogeneic HCT and has served as a new strategy for measuring minimal residual disease before and after allogeneic HCT. Using high intensity conditioning regimens has emerged as a potential strategy to reduce risk of relapse and improve overall survival, especially in patients with minimal residual disease prior to allogeneic HCT. SUMMARY: As access to allogeneic HCT continues to improve, also, with more refined prognostic strategies, the field continues to move to optimize transplantation approaches by decreasing the risk of relapse and minimizing transplant-related complications.
Authors: Dennis D H Kim; Igor Novitzky Basso; Taehyung Simon Kim; Seong Yoon Yi; Kyoung Ha Kim; Tracy Murphy; Steven Chan; Mark Minden; Ivan Pasic; Wilson Lam; Arjun Law; Fotios V Michelis; Armin Gerbitz; Auro Viswabandya; Jeffrey Lipton; Rajat Kumar; Stanley W K Ng; Tracy Stockley; Tong Zhang; Ian King; Jonas Mattsson; Jean C Y Wang Journal: EJHaem Date: 2022-05-23
Authors: Muhammad Umair Mushtaq; Moazzam Shahzad; Amna Y Shah; Sibgha Gull Chaudhary; Muhammad U Zafar; Iqra Anwar; Karun Neupane; Ayesha Khalid; Nausheen Ahmed; Rajat Bansal; Ramesh Balusu; Anurag K Singh; Sunil H Abhyankar; Natalie S Callander; Peiman Hematti; Joseph P McGuirk Journal: Front Immunol Date: 2022-10-03 Impact factor: 8.786