Is There Still a Role for Autologous Stem Cell Transplantation for the Treatment of Acute Myeloid Leukemia?

被引:21
作者
Ferrara, Felicetto [1 ,2 ]
Picardi, Alessandra [1 ,2 ,3 ]
机构
[1] AORN Cardarelli Hosp, Div Hematol, I-80128 Naples, Italy
[2] AORN Cardarelli Hosp, Stem Cell Transplantat Program, I-80128 Naples, Italy
[3] Univ Tor Vergata, Dept Biomed & Prevent, I-00119 Rome, Italy
关键词
acute myeloid leukemia; autologous transplantation; post-remission therapy; minimal residual disease; MEASURABLE RESIDUAL DISEASE; ACUTE MYELOCYTIC-LEUKEMIA; TERM-FOLLOW-UP; EUROPEAN-SOCIETY; RISK-STRATIFICATION; ELDERLY-PATIENTS; WORKING PARTY; 1ST REMISSION; MARROW; BLOOD;
D O I
10.3390/cancers12010059
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
After intensive induction chemotherapy and complete remission achievement, patients with acute myeloid leukemia (AML) are candidates to receive either high-dose cytarabine-based regimens, or autologous (ASCT) or allogeneic (allo-SCT) hematopoietic stem cell transplantations as consolidation treatment. Pretreatment risk classification represents a determinant key of type and intensity of post-remission therapy. Current evidence indicates that allo-SCT represents the treatment of choice for high and intermediate risk patients if clinically eligible, and its use is favored by increasing availability of unrelated or haploidentical donors. On the contrary, the adoption of ASCT is progressively declining, although numerous studies indicate that in favorable risk AML the relapse rate is lower after ASCT than chemotherapy. In addition, the burden of supportive therapy and hospitalization favors ASCT. In this review, we summarize current indications (if any) to ASCT on the basis of molecular genetics at diagnosis and minimal residual disease evaluation after induction/consolidation phase. Finally, we critically discuss the role of ASCT in older patients with AML and acute promyelocytic leukemia.
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页数:13
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