What time is the right time for transplantation?

On June 29, 2023, the AML Hub hosted a discussion on “What time is the right time for transplantation?”, chaired by Selina Luger, with contributions from Steering Committee members Gert Ossenkoppele, Jeffrey Lancet, Yasushi Miyazaki, Eduardo Rego, Roland Walter, and Jorge Sierra.

Using a case of a patient with primary refractory acute myeloid leukemia (AML), Luger discusses the options of immediate allogeneic stem cell transplantation or after achievement of remission with salvage chemotherapy. Luger then highlights the phase III ASAP trial (previously covered by the AML Hub), the Pre-MEASURE trial (previously covered by the AML Hub), and also describes a study that found allogeneic stem cell transplantation outcomes were associated with high-sensitivity detection of FLT3-internal tandem duplication measurable residual disease.

The group discusses the results of these studies, including the differences in patient populations, optimal timing of transplantation, the impact of pretransplant measurable residual disease, and whether or not salvage chemotherapy is beneficial for these patients. They also raise the importance of identifying donors for potential transplantation as early as possible.