Guidelines for indications for HCT in adult patients with AML
| . | MSD . | MUD . | UCB . | Haplo-identical . |
|---|---|---|---|---|
| First remission | ||||
| Favorable cytogenetics | ||||
| APL | No | No | No | No |
| CBF-AML* | No | No | No | No |
| With mKIT | Uncertain | Uncertain | Uncertain | Uncertain |
| Without mKIT | No | No | No | No |
| CN-AML* | Yes | Uncertain | Uncertain | Uncertain |
| “mNPM1 without FLT3ITD” | No | No | No | No |
| “mCEBPA”† | No | No | No | No |
| Others than above | Yes | Uncertain | Uncertain | Uncertain |
| Intermediate risk with abnormal cytogenetics | Yes | Uncertain | Uncertain | Uncertain |
| Adverse | Yes | Yes | Yes‡ | Yes‡ |
| Second remission | Yes | Yes | Yes‡ | Yes‡ |
| Not in remission§ | Yes | Yes | Uncertain | Uncertain |
| . | MSD . | MUD . | UCB . | Haplo-identical . |
|---|---|---|---|---|
| First remission | ||||
| Favorable cytogenetics | ||||
| APL | No | No | No | No |
| CBF-AML* | No | No | No | No |
| With mKIT | Uncertain | Uncertain | Uncertain | Uncertain |
| Without mKIT | No | No | No | No |
| CN-AML* | Yes | Uncertain | Uncertain | Uncertain |
| “mNPM1 without FLT3ITD” | No | No | No | No |
| “mCEBPA”† | No | No | No | No |
| Others than above | Yes | Uncertain | Uncertain | Uncertain |
| Intermediate risk with abnormal cytogenetics | Yes | Uncertain | Uncertain | Uncertain |
| Adverse | Yes | Yes | Yes‡ | Yes‡ |
| Second remission | Yes | Yes | Yes‡ | Yes‡ |
| Not in remission§ | Yes | Yes | Uncertain | Uncertain |
Uncertain implies insufficient published data for a recommendation.
APL indicates acute promyelocytic leukemia; CBF, core binding factor [t(8;21) or Inv(16)]; CN-AML, cytogenetically normal AML; FLT3ITD, FMS-related tyrosine kinase 3–internal tandem duplication; HCT, hematopoietic cell transplantation; mCEBPA, mutated CEBPA; mKIT, KIT mutations; MSD, matched sibling donor; mNPM1, mutated NPM1; MUD, matched unrelated donor; and UCB, umbilical cord blood.
If the data on molecular markers are not available.
Increasing data show that the beneficial effect may be restricted only to patients with double mutations.
Only at experienced centers and in the absence of a timely available MUD.
Carefully selected patients with good performance status and low disease burden; CIBMTR risk score may aid the patient selection.