Indication of allogeneic hematopoietic cell transplantation for patients with acute myeloid leukemia: from a pediatrician’s view

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  • Tomizawa Daisuke
    Division of Leukemia and Lymphoma, Children’s Cancer Center, National Center for Child Health and Development

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  • 急性骨髄性白血病における同種造血細胞移植の適応：小児科医の視点

Abstract

<p> Indication of allogeneic hematopoietic cell transplantation (HCT) for children with acute myeloid leukemia (AML) is determined by leukemia-specific recurrent cytogenetics/molecular genetics and treatment response, and generally restricted to high-risk group in terms of reducing late effects. However, recent advances in genetic analysis, identification of rare prognostic subgroups through international collaborations, and introduction of measurable residual disease (MRD) assessment by multiparameter flow cytometry have made a shift of certain subgroups of patients from intermediate-risk to high-risk group, thus, indication of HCT is rather expanding these days. On the other hand, further improvement in outcome of pediatric AML is unlikely by simply allocating potentially high-risk patients to allogeneic HCT. Therefore, incorporation of novel molecular targeted drugs and re-consideration of HCT indications on the bases of new therapy platform is necessary. Further more, cooperation between pediatricians and adult hematologists would be critical for further improvements in AML therapy including care for adolescent and young adult (AYA) patients.</p>

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