Can reduced-intensity allogeneic transplantation cure older adults with AML?

Minimal residual disease diagnostics in myeloid malignancies in the post transplant period

“…This clinical variability is seen also after allogeneic SCT (allo-SCT), which is important in MDS, the CMPD and also in AML, 4 as reduced intensity conditioning (RIC) allows the inclusion of elderly patients or patients with comorbidities. 5 However, 30-80% of all patients with myeloid malignancies relapse after SCT depending on the subentity, the genetically based risk profile, and other parameters such as the remission status at the time of SCT. Withdrawal of immunosuppression or use of donor lymphocyte infusions (DLIs) are interesting options for impending relapse after SCT 6,7 that justify further evaluation.…”

Reduced intensity conditioning allogeneic stem cell transplantation for patients with acute myeloid leukemia: long term results of a ‘donor’ versus ‘no donor’ comparison

“…1 Reduced-intensity conditioning (RIC) regimens have emerged as an attractive modality to decrease TRM. 2,3 However, the issue of possible higher relapse rate after RIC-allo-SCT is still under Induction chemotherapy consisted of intravenous administration of daunorubicin (60 mg/m 2 /day for 3 days) and cytarabine (100 mg/m 2 /day as continuous infusion for 7 days). Patients who failed to enter complete remission after this first induction regimen, received a second course of salvage induction with idarubicin (8 mg/m 2 /day for 5 days) instead of daunorubicin and cytarabine (100 mg/m 2 /day as continuous infusion for 7 days).…”

“…1 Although several studies addressing the JAK2 genotype in MPN as well as the hematopoietic progenitors targeted by JAK2 mutation and the frequency of this event based on molecular analyses of purified bone marrow cell populations (both myeloid and lymphoid) have already been published, [2][3][4] there is to date no published technique for the morphological identification of JAK2 mutV617F positive cells in MPN.…”

Comparable outcomes between autologous and allogeneic transplant for adult acute myeloid leukemia in first CR

“…167,168 Case series and analysis of registry data have reported encouraging results, with 40% to 60% 2-year OS rates and 20% nonrelapse mortality for patients who underwent transplant in remission. 167,168 In a retrospective analysis comparing outcomes with RIC allogeneic HSCT and autologous HSCT in patients aged 50 years and older based on large registry data, allogeneic HSCT was associated with lower risk for relapse and superior DFS and OS relative to autologous HSCT. 167 The authors also noted that a survival benefit was not observed in the subgroup of patients undergoing allogeneic HSCT in first CR because of an increased incidence of nonrelapse mortality.…”