The European LeukemiaNet AML Working Party consensus statement on allogeneic HSCT for patients with AML in remission: an integrated-risk adapted approach
Por:
Cornelissen, JJ, Gratwohl, A, Schlenk, RF, Sierra, J, Bornhauser, M, Juliusson, G, Racil, Z, Rowe, JM, Russell, N, Mohty, M, Lowenberg, B, Socie, G, Niederwieser, D, Ossenkoppele, GJ
Publicada:
1 oct 2012
Resumen:
Allogeneic haematopoietic stem-cell transplantation (HSCT) is frequently applied as part of the treatment in patients with acute myeloid leukaemia (AML) in their first or subsequent remission. Allogeneic HSCT reduces relapse, but nonrelapse mortality and morbidity might counterbalance this beneficial effect. Here, we review recent studies reporting new disease-specific prognostic markers, in addition to allogeneic-HSCT-related risk factors, which can be assessed at specific time points during treatment. We propose risk assessment as a dynamic process during treatment, incorporating both disease-related and transplant-related factors for the decision to proceed either to allogeneic HSCT or to apply a nontransplant strategy. We suggest that allogeneic HSCT might be favoured if the projected disease-free survival is expected to improve by at least 10% based on an individual's risk assessment. The approach requires initial disease risk assessment, identifying a sibling or unrelated donor soon after diagnosis and the incorporation of time-dependent risk factors, all within the context of an integrated therapeutic management approach.
Filiaciones:
Cornelissen, JJ:
Erasmus Univ, Med Ctr, Dept Hematol, NL-3075 EA Rotterdam, Netherlands
Gratwohl, A:
Univ Basel Hosp, CH-4031 Basel, Switzerland
Schlenk, RF:
Univ Hosp, Ulm, Germany
Sierra, J:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Bornhauser, M:
Univ Hosp Carl Gustav Carus, Dresden, Germany
Juliusson, G:
Lund Univ, Lund, Sweden
Racil, Z:
Masaryk Univ, Brno, Czech Republic
Univ Hosp, Brno, Czech Republic
Rowe, JM:
Shaare Zedek Med Ctr, Jerusalem, Israel
Russell, N:
Univ Nottingham Hosp, Nottingham NG7 2UH, England
Mohty, M:
St Antoine Hosp, Paris, France
Lowenberg, B:
Erasmus Univ, Med Ctr, Dept Hematol, NL-3075 EA Rotterdam, Netherlands
Socie, G:
Hosp St Louis, Paris, France
Niederwieser, D:
Univ Leipzig, Leipzig, Germany
Ossenkoppele, GJ:
Vrije Univ Amsterdam Med Ctr, Amsterdam, Netherlands
Open Access
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