Professional Statements and Societal Positions Guidelines
National Comprehensive Cancer Network – 2021
The National Comprehensive Cancer Network clinical guidelines (v.3.2021), for acute myeloid leukemia state that allogeneic HCT is recommended for [individuals] aged less than 60 years after standard-dose cytarabine induction with induction failure or significant residual disease without a hypocellular marrow. It is also recommended after high-dose cytarabine induction with induction failure, or as post-remission therapy in those with intermediate-risk or poor-risk cytogenetics.
Allogeneic HCT is identified as a "reasonable option" for patients aged greater than or equal to 60 years after standard-dose cytarabine induction with residual disease or induction failure or following complete response (preferably in a clinical trial). In addition, allogeneic HCT is recommended for relapsed or refractory disease.
According to the guidelines, the role of autologous HCT is diminishing due to improvements in allogeneic HCT that have expanded the pool of potential donors outside the family setting. Autologous HCT should not be a recommended consolidation therapy outside the setting of a clinical trial.