Abstract

Hematopoeitic stem cell transplantation (HSCT) has been an important modality for the treatment and cure of patients with high risk acute myeloid leukemia (AML). Improved stratification of AML patients with genetic markers (e.g. FLT3, CEBPA, NPM1 and others) has allowed better selection of patients for HSCT. Outstanding results from cord blood and haploidentical transplants have also increased the availability of donors for transplantation. Novel drugs like hypomethylating agents, BCL-2 inhibitors and various FLT 3 inhibitors have also improved the remission status of patients before transplant while also facilitating post-transplant consolidation and maintenance to improve disease control. Transplantation of older patients has also been made possible by the reduction of transplant-related mortality and morbidity through improved pre-transplant conditioning regimens and better management of post-transplant complications. Cellular engineering has also made possible the expansion of hematopoietic stem and progenitor cells to improve the results of HSCT while genetic engineering and expansion of cellular subsets has facilitated targeted therapy against viruses and leukemia. The outcomes of HSCT for the treatment of AML has improved significantly due to the above measures and HSCT remains a mainstay in the treatment of this disease.

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