Allogeneic stem cell transplantation for patients with acute myeloid leukemia in first complete remission: towards a personalized approach based on individual risk assessment

Allogeneic hematopoietic stem cell transplantation (alloHSCT) from an HLA-identical sibling donor is generally recommended for patients with acute myeloid leukemia (AML) in first complete remission (CR) with intermediate or high-risk cytogenetic profile. As the benefit of alloHSCT in terms of overall survival is compromised by nonrelapse mortality (NRM), it is important to weigh the most significant variables that affect the risk of relapse and variables that predict for NRM. Prognostic markers are related to the molecular and cytogenetic profile of the leukemia and on the other hand to parameters, including comorbidities, Karnofsky, age, and transplantrelated factors (type of donor, source of graft, conditioning regimen), that relate to NRM. Given the complexity of decision-making, an approach that integrates different sets of risk factors, was recently developed and reported by the acute myeloid leukemia working party of the European Leukemia Net