Hematopoietic stem cell transplantation for acute myeloid leukemia

Int J Hematol. 2018 May;107(5):513-518. doi: 10.1007/s12185-018-2412-8. Epub 2018 Jan 27.


Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) yields a high rate of curability for acute myeloid leukemia (AML), it is also associated with transplant-related morbidity and mortality (TRM). The risk and severity of TRM increase with the use of an alternative donor graft in the absence of an HLA-matched sibling donor (MSD). With the declining birthrate and aging of the population, the numbers of patients with an MSD are decreasing, and alternative donor transplants, including the post-transplant cyclophosphamide method using haplo-identical donors, are increasing. Autologous (auto)-HSCT, which enables the intensification of chemotherapy, has the advantage of high availability of a transplant graft, and is associated with a lower TRM, but these benefits may be offset by a higher rate of relapse due to the lack of a graft-versus-leukemia (GVL) effect. Although allo-HSCT remains the first-line treatment for poor and very-poor-risk patients, auto-HSCT is again gaining increased attention. It has also recently been suggested that cord blood grafts may induce a stronger GVL effect than other grafts; as such, the positioning of cord blood transplantation should also be reconsidered for AML patients.

Keywords: Acute myeloid leukemia; Autologous transplantation; Cord blood transplantation; Hematopoietic stem cell transplantation.

Publication types

  • Review

MeSH terms

  • Allografts
  • Autografts
  • Cord Blood Stem Cell Transplantation
  • Graft vs Leukemia Effect
  • HLA Antigens
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / mortality
  • Histocompatibility
  • Humans
  • Leukemia, Myeloid, Acute / therapy*
  • Risk
  • Siblings


  • HLA Antigens