Allogeneic stem cell transplantation for AML – which patients benefit?

Allogeneic stem cell transplantation is an established consolidation therapy for AML. It can cure a significant proportion of patients, however, the procedure has a considerable morbidity and mortality. The results depend from disease related issues, patient related issues and donor related issues. In brief, best results can be obtained in earlier disease course (1st or 2nd remission), in patients without genetical high-risk and in patients with chemosensitive disease. Important donor-related issues correlating with a superior outcome are the degree of HLA-match and a non-high-risk CMV seroconstellation between patient and donor. The biological age of the patient and comorbidities have an inverse correlation with outcome after transplantation. Generally, a comprehensive discussion of allogeneic transplantation versus conventional therapy with the patient and his relatives is mandatory prior to decision making pro or con an allograft.