Stem cell transplantation for acute myeloid leukaemia in adults

Gone are the days when a patient with acute myeloid leukaemia (AML) would die waiting for a suitable donor for allogenic stem cell transplantation. With improved supportive care, we can now confidently provide unrelated donor transplant to most patients. The adult patient who does not have a suitable donor can be considered to have a haploidentical transplant or a cord transplant. In fact, a combination of cord and haploidentical transplant can be thought of in carefully selected patients. With new-age molecular diagnostics incorporating genetic mutational analysis along with the cytogenetic model, minimal residual disease monitoring and novel transplant techniques, we can now confidently say that we are able to provide transplantation to most patients. In this review, we will shortly go through the prognostics in AML followed by the transplant options in patients who lack a suitable matched donor—either family or voluntary unrelated.