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Indications for allogeneic hematopoietic cell transplantation for adults with Philadelphia-chromosome negative acute lymphoblastic leukemia in first complete remission: all about MRD?

Bone Marrow Transplantation volume 54, pages 3–5 (2019)Cite this article

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Allogeneic hematopoietic cell transplantation (HCT) consolidation has an established record of curing acute lymphoblastic leukemia (ALL) in a subset of adult patients. Historically, the majority of adults with ALL were deemed high-risk, and thus, allogeneic HCT was offered more broadly as a consolidation in suitable candidates at a time when effective salvage regimens for relapsed ALL were lacking. Allogeneic HCT was particularly recommended to consolidate high-risk adult ALL defined based on traditional risk factors such as cytogenetics, older age, and elevated initial white blood cell count. Several prospective studies were conducted that utilized biological randomization to examine the benefit of allogeneic HCT in adults with ALL who attained first complete remission (CR1). The majority of these studies illustrated superiority of HCT over chemotherapy consolidation in reducing leukemia relapse, and several of those studies even demonstrated survival advantage with the transplantation approach [1,2,3]. Nevertheless, who attains the most benefit from early allogeneic HCT was and still remains a matter of debate.

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Authors and Affiliations

  1. Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA, USA

    Ibrahim Aldoss & Vinod Pullarkat

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  1. Ibrahim Aldoss
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  2. Vinod Pullarkat
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Correspondence to Ibrahim Aldoss.

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Aldoss, I., Pullarkat, V. Indications for allogeneic hematopoietic cell transplantation for adults with Philadelphia-chromosome negative acute lymphoblastic leukemia in first complete remission: all about MRD?. Bone Marrow Transplant 54, 3–5 (2019). https://doi.org/10.1038/s41409-018-0398-8

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