In this review, the authors discuss the current status of reduced-intensity conditioning (RIC) hematopoietic cell transplantation (HCT) in treating acute myelogenous leukemia (AML). They note that RIC regimens are now preferred because of their potent graft-versus-leukemia (GVL) effect while minimizing treatment-related toxicity in older patients or those with comorbidities. However, whether RIC transplantation is indicated in younger transplant patients is less clear, according to the authors, citing a prospective randomized trial of myeloablative (MA) vs. RIC regimens (BMT-CTN 0901) that was recently closed when early results indicated better outcomes for MA regimens. Additional reviews of recent publications offer updated efficacy and toxicity data comparing RIC and MA regimens. The authors conclude that RIC transplants will likely remain the standard of care because many patients with AML are not eligible for myeloablative conditioning.
Reshef R, et al. Bone Marrow Transplant