Transcript Related Guidelines

Is There Still a Role for AuSCT in AML?

Adriano Venditti, MD · Tor Vergata University of Rome

Disclosures

October 08, 2020

This transcript has been edited for clarity.  

Autologous stem cell transplantation has been for a long time considered a possible option for treating patients with acute myeloid leukemia after consolidation therapy. Actually, this is quite a long and controversial affair. The very initial results published by the NCRI (National Cancer Research Institute) group almost 20 years ago demonstrated no benefit from the autologous stem cell transplant option for patients with acute myeloid leukemia. 

More recently, the HOVON-SAKK (The Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research) group published in 2011, more precisely, a study that investigated in a randomized fashion the role of autologous stem cell transplant in acute myeloid leukemia.[1] In this very large series of patients, the Dutch colleagues found that indeed there was a benefit for patients from the autologous stem cell transplant option.[2] I have to say that more recently, the European LeukemiaNet recommendation actually found that there is still room for autologous stem cell transplant in very, very selected situations—for instance, patients belonging to the intermediate category who achieve after consolidation an MRD (minimal residual disease)-negative complete remission.[3,4,5] 

So, these recommendations are quite relevant in this statement. Because on one side, they reinforce the role of autologous stem cell transplant again in select situations. On the other side, they emphasize the role of minimal residual disease detection. Actually, MRD assessment can be a sort of driver to address or not given patients to an autologous stem cell transplant option.

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