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Relapse of AML after hematopoietic stem cell transplantation: methods of monitoring and preventive strategies. A review from the ALWP of the EBMT

Bone Marrow Transplantation volume 51, pages 1431–1438 (2016)Cite this article

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-SCT) remains the therapeutic method with the most potent anti-leukemic activity mediated by the graft versus leukemia effect. However, a significant proportion of patients with AML will relapse after allo-SCT. The prognosis for these patients is dismal, with a probability of long-term survival of <20%. Data from previous studies have shown that disease-specific prognostic factors, are in general, the same as those in patients treated with conventional chemotherapy. Minimal residual disease (MRD) and chimerism status monitoring after allo-SCT may be used as predictors of impending relapse and should be part of routine follow-up for AML patients. A significant number of studies have shown that pre-emptive administration of donor lymphocyte infusion (DLI) based on MRD and chimerism monitoring, as well as prophylactic DLI in AML patients at high risk of relapse is effective in preventing relapse. In this review, we discuss strategies for the identification of high-risk patients, review current therapeutic options and provide our recommendations for the management of post-SCT AML.

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Author notes

  1. P Tsirigotis and M Byrne: These authors contributed equally to this work.

  2. B N Savani and A Nagler: Co-senior authors.

Authors and Affiliations

  1. Second Department of Internal Medicine, Division of Hematology, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece

    P Tsirigotis

  2. Department of Medicine, Hematology and Stem Cell Transplant Section, Vanderbilt University Medical Center, Nashville, TN, USA

    M Byrne & B N Savani

  3. Department of Hematology and Oncology, Klinikum Augsburg, University of Munich, Augsburg, Germany

    C Schmid

  4. Department of Medicine, Division of Hematology, University of Liège, Liège, Belgium

    F Baron

  5. Hematology, IRCCS San Raffaele Scientific Institute, University Vita-Salute San Raffaele, Milano, Italy

    F Ciceri

  6. Department of Hematology, Hospital Clinic, Barcelona, Spain

    J Esteve

  7. Department of Hematology, Saint Antoine Hospital, APHP and University UPMC, Paris, France

    N C Gorin

  8. Maria Sklodowska-Curie Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland

    S Giebel

  9. Department of Haematology, Saint Antoine Hospital, Paris, France

    M Mohty

  10. Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel

    A Nagler

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  1. P Tsirigotis
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  2. M Byrne
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  3. C Schmid
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  4. F Baron
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  5. F Ciceri
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  6. J Esteve
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  7. N C Gorin
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  8. S Giebel
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  9. M Mohty
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  10. B N Savani
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  11. A Nagler
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Corresponding author

Correspondence to B N Savani.

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Tsirigotis, P., Byrne, M., Schmid, C. et al. Relapse of AML after hematopoietic stem cell transplantation: methods of monitoring and preventive strategies. A review from the ALWP of the EBMT. Bone Marrow Transplant 51, 1431–1438 (2016). https://doi.org/10.1038/bmt.2016.167

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  • DOI: https://doi.org/10.1038/bmt.2016.167

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