Impact of Remission Induction Chemotherapy Prior to Allogeneic SCT in Relapsed and Poor-response Patients With AML

Inclusion Criteria

• •Signed written informed consent.
• •Male and female patients of 18 to 75 years of age.
• •Diagnosis of AML according to WHO criteria.
• •Patient is fit for aggressive induction chemotherapy and transplantation by assessment of an experienced hematologist.
• •No history of chronic pulmonary disease and absence of dyspnea. Otherwise, documented diffusion lung capacity for carbon monoxide ( DLCO ) ≤ 40 percent ( adjusted for hemoglobin, if available ) and FEV1 / FVC ≥ 50 percent.
• •HLA - identical sibling. or
• •HLA - compatible unrelated donor ( ≥ 9 /10 antigens matched for HLA - A, - B, - C, -DRB 1, and - DQB 1 ) with completed confirmatory typing or
• •Two unrelated donors with \> 90 percent probability of a 9 /10 match for HLA - A, - B, - C, - DRB 1, and - DRQB 1, according to Opti Match ® list.
• •For the relapse stratum
• •First AML relapse, defined as ≥ 5 percent bone marrow blasts and / or extramedullary AML manifestation.
• •For the poor - responders stratum
• •AML that evolves from previously documented myelodysplastic syndrome ( MDS ),
• •and / or
• •diagnosis of therapy-related myeloid neoplasm ( t - MN ), and / or
• •a ) If patient ≤ 60 years old adverse risk AML according to ELN - criteria and ≥ 5 percent bone marrow blasts after the first cycle of induction therapy.
• •b ) If patient \> 60 years old non-favourable risk AML according to ELN - criteria and ≥ 5 percent bone marrow blasts after the first cycle of induction therapy.