Abstract
Allogeneic hematopoietic stem cell transplant (alloHSCT) is potentially curative for acute myeloid leukemia (AML) otherwise incurable with chemotherapy. Outcomes are influenced by disease status and a variety of AML-specific prognostic variables. The mechanism of alloHSCT is a graft-versus-leukemia effect that combines synergistically with potent cytotoxic conditioning regimens. Risk stratification for AML continues to be refined to better select alloHSCT candidates and is starting to include dynamic risk prognostication with measurable residual disease testing. Myeloablative conditioning regimens are standard in younger patients, while reduced intensity conditioning is frequently offered for patients in their 60s, and 70s. Alternative donor approaches for AML with umbilical cord blood and related haploidentical alloHSCT have proven efficacy in AML and have expanded transplant to those without matched donors. Challenges to a successful transplant include graft-versus-host disease, AML recurrence and preparative regimen-related toxicity, and several lines of research are ongoing trying to address these limitations.
Published Version
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