Should persons with acute myeloid leukemia have a transplant in first remission?

Abstract

Despite more than 40 years of extensive study, it remains uncertain which individuals, if any, with acute myelogenous leukemia (AML) in first remission should receive a blood cell or bone marrow transplant versus post-remission chemotherapy (or both). Nevertheless, there is a recent trend toward recommending more transplants in this setting. We consider four myths underlying this recommendation: (1) only individuals achieving second remission benefit from a transplant; (2) there is no effective therapy for relapse other than an allotransplant; (3) we can accurately predict which individuals with AML in first remission need a transplant; and (4) detection of minimal residual disease in first remission will resolve this controversy. We discuss these misconceptions and suggest approaches to resolve this issue.

• Authors: R P Gale, P H Wiernik, H M Lazarus
• Journal: Leukemia (Leukemia) Vol. 28 Issue 10 Pg. 1949-52 (Oct 2014) ISSN: 1476-5551 [Electronic] England
• PMID: 24727674 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antineoplastic Agents

Topics

• Antineoplastic Agents (chemistry)
• Bone Marrow Transplantation (methods)
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Leukemia, Myeloid, Acute (therapy)
• Neoplasm, Residual
• Recurrence
• Remission Induction
• Time Factors
• Transplantation, Homologous
• Treatment Outcome