Alternative donor transplantation for acute myeloid leukemia

Nelli Bejanyan, Housam Haddad, Claudio Brunstein

Research output: Contribution to journalArticlepeer-review

Abstract

Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapy for adult patients with acute myeloid leukemia (AML), but its use for consolidation therapy after first remission with induction chemotherapy used to be limited to younger patients and those with suitable donors. The median age of AML diagnosis is in the late 60s. With the introduction of reduced-intensity conditioning (RIC), many older adults are now eligible to receive allo-HCT, including those who are medically less fit to receive myeloablative conditioning. Furthermore, AML patients commonly have no human leukocyte antigen (HLA)-identical or medically suitable sibling donor available to proceed with allo-HCT. Technical advances in donor matching, suppression of alloreactivity, and supportive care have made it possible to use alternative donors, such as unrelated umbilical cord blood (UCB) and partially HLA-matched related (haploidentical) donors. Outcomes after alternative donor allo-HCT are now approaching the outcomes observed for conventional allo-HCT with matched related and unrelated donors. Thus, with both UCB and haploidentical donors available, lack of donor should rarely be a limiting factor in offering an allo-HCT to adults with AML.

Original languageEnglish (US)
Pages (from-to)1240-1268
Number of pages29
JournalJournal of Clinical Medicine
Volume4
Issue number6
DOIs
StatePublished - Jun 10 2015

Keywords

  • Alternative donor
  • AML
  • Haploidentical
  • Transplantation
  • UCB

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