Allogeneic stem cell transplantation in acute myeloid leukemia in first or subsequent remission: Weighing prognostic markers predicting relapse and risk factors for non-relapse mortality

Allogeneic hematopoietic stem cell transplantation (alloSCT) has been established as a powerful treatment modality in acute myeloid leukemia (AML) in first or subsequent remission. Although alloSCT effectively prevents relapse, non-relapse mortality (NRM) associated with the procedure may counterbalance that beneficial effect. As a result, alloSCT generally is restricted to patients with a relatively high risk of relapse and a relatively low risk for NRM. Here, we review recent studies that evaluated specific risk factors that, on the one hand, identified categories of AML patients with a higher risk of relapse and, on the other hand, identified patients with an increased risk for NRM. We discuss how these recent developments may affect our decision-making about whether and when to proceed to alloSCT. © 2008 Elsevier Inc. All rights reserved.