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Should persons with acute myeloid leukemia have a transplant in first remission?

Leukemia volume 28, pages 1949–1952 (2014)Cite this article

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Abstract

Despite more than 40 years of extensive study, it remains uncertain which individuals, if any, with acute myelogenous leukemia (AML) in first remission should receive a blood cell or bone marrow transplant versus post-remission chemotherapy (or both). Nevertheless, there is a recent trend toward recommending more transplants in this setting. We consider four myths underlying this recommendation: (1) only individuals achieving second remission benefit from a transplant; (2) there is no effective therapy for relapse other than an allotransplant; (3) we can accurately predict which individuals with AML in first remission need a transplant; and (4) detection of minimal residual disease in first remission will resolve this controversy. We discuss these misconceptions and suggest approaches to resolve this issue.

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Acknowledgements

RPG acknowledges support from the NIHR Biomedical Research Centre funding scheme. Drs Elisabeth Paietta and Gary Schiller kindly reviewed the typescript.

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Authors and Affiliations

  1. Division of Experimental Medicine, Department of Medicine, Haematology Research Centre, Imperial College London, London, UK

    R P Gale

  2. Cancer Research Foundation of New York, Chappaqua, NY, USA

    P H Wiernik

  3. University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA

    H M Lazarus

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  1. R P Gale
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  2. P H Wiernik
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  3. H M Lazarus
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Correspondence to R P Gale.

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Competing interests

RPG is a part-time employee of Celgene Corp. PHW is a speaker for Celgene Corp., Novartis and Janssen. HML is a consultant to Actinium Pharmaceuticals, Inc. and Pluristem Therapeutics, Inc. and a speaker for Celgene Corp. Dr Charles Schiffer claims he recently heard Galen comment on his remedy.

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Gale, R., Wiernik, P. & Lazarus, H. Should persons with acute myeloid leukemia have a transplant in first remission?. Leukemia 28, 1949–1952 (2014). https://doi.org/10.1038/leu.2014.129

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