Treatment of Acute Myeloid Leukemia With Hematopoietic Stem Cell Transplantation

Cortney V. Jones; Edward A. Copelan


Future Oncol. 2009;5(4):559-568. 

In This Article

Abstract and Introduction


Allogeneic hematopoietic stem cell transplantation provides the most powerful antileukemic effect in the treatment of acute myeloid leukemia. Due to its significant morbidity and mortality, it should be used in first remission patients whose relapse risk is substantial. Reduced intensity transplantation is safer and extends the application of early transplantation to older patients and those with comorbidities. In patients with advanced disease, allotransplantation provides a lower chance for cure, but is often the only curative treatment available. Advances in histocompatibility typing and supportive care have improved results of allogeneic transplantation in acute myeloid leukemia.


The use of allogeneic hematopoietic stem cell transplantation (HSCT) in acute leukemia dates from the 1970s, when Thomas and colleagues reported the cure of some patients with endstage leukemia using allogeneic marrow from human leukocyte antigen (HLA)-identical siblings following a myeloablative preparative regimen of total body radiation (TBI) and cyclophosphamide.[1] Shortly thereafter, the same group reported that transplantation in first remission was successful in achieving sustained remission in a majority of patients with acute myeloid leukemia (AML),[2] and that the incidence of leukemic relapse was reduced in patients who developed graft-versus-host disease (GVHD).[3] These groundbreaking studies form the basis for the present use of HSCT in AML.


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