Indication of allogeneic hematopoietic stem cell transplantation for patients with acute myeloid leukemia: from a viewpoint of physicians

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  • Miyao Kotaro
    Department of Hematology and Oncology, Anjo Kosei Hospital

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  • 急性骨髄性白血病における同種移植の適応：内科医の視点から

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<p> In adults with acute myeloid leukemia (AML), indication of allogeneic stem cell transplantation (HSCT) is warranted in cases of intermediate or poor prognosis during the first complete remission. While clinical constraints exist, advancements in genetic analysis and techniques for measuring minimal residual disease have improved the accuracy of AML prognostication. Concurrently, the therapeutic outcomes of allogeneic HSCT have improved, and the use of alternative stem cell sources such as umbilical cord blood has become more accessible. As a result, the indications for allogeneic HSCT in adult AML continue to evolve, reflecting progress in both prognostication and transplant therapy.</p><p> When considering a seamless approach to allogeneic HSCT eligibility in pediatric and adult populations, the transitional period of adolescent and young adulthood (AYA) emerges as an important demographic. AYA AML patients exhibit favorable outcomes with both chemotherapy and allogeneic HSCT compared to other adult age group. However, the benefit of pediatric-style intensified regimens in chemotherapy is unproven, and there are challenges with late complications and social limitations post-transplantation. Collaborative efforts between pediatricians and adult hematologists in addressing the AYA population would likely contribute to overall advancements in the treatment of AML across all age groups.</p>

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