The role of allogeneic stem cell transplantation in the management of acute myeloid leukaemia: a triumph of hope and experience

Research output: Contribution to journalReview articlepeer-review

Abstract

Acute myeloid leukaemia (AML) is the commonest indication for allogeneic stem cell transplantation (allo-SCT) worldwide. The accumulated experience of allografting in AML over the last four decades has provided critical insights into both the contribution of the conditioning regimen and the graft-versus-leukaemia effect to the curative potential of the most common form of immunotherapy utilised in standard clinical practice. Coupled with advances in donor availability and transplant technologies, this has resulted in allo-SCT becoming an important treatment modality for the majority of adults with high-risk AML. At the same time, advances in genomic classification, coupled with progress in the accurate quantification of measurable residual disease, have increased the precision with which allo-mandatory patients can be identified, whilst simultaneously permitting accurate identification of those patients who can be spared the toxicity of an allograft. Despite this progress, disease recurrence still remains a major cause of transplant failure and AML has served as a paradigm for the development of strategies to reduce the risk of relapse - notably the novel concept of post-transplant maintenance, utilising pharmacological or cellular therapies.

Bibliographic note

© 2019 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.

Details

Original languageEnglish
Pages (from-to)129-146
Number of pages18
JournalBritish Journal of Haematology
Volume188
Issue number1
Early online date10 Dec 2019
Publication statusPublished - 21 Dec 2019

Keywords

  • acute myeloid leukaemia, allogeneic stem cell transplantation, graft‐versus‐host disease, graft‐versus‐leukaemia