Journal
BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY
Volume 21, Issue 1, Pages 85-92Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.beha.2007.11.013
Keywords
hematopoietic cell transplantation; acute myeloid leukemia; minimal residual disease; chemotherapy; PCR-based assays; multicolor flow cytometry
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Current strategies for incorporating hematopoietic cell transplantation into the treatment of adults with AML are based predominantly on pre-treatment patient, donor and disease characteristics. These strategies, while useful, have significant shortcomings in that they recommend deferred transplantation for many patients who would benefit from earlier intervention and, at the same time, direct other patients who would be cured with chemotherapy alone to the more risky and toxic approach of early transplantation. Here we review the currently accepted indications for transplantation and raise the possibility that alternative approaches to incorporating transplantation into the management of adults with AM L that rely predominantly on the measurement of minimal residual disease (MRD) could save additional lives without any major advance in chemotherapy or transplant technologies.
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