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Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2023; 11(2): 268-291
Published online Jan 16, 2023. doi: 10.12998/wjcc.v11.i2.268
Allogeneic stem cell transplantation in the treatment of acute myeloid leukemia: An overview of obstacles and opportunities
Yong-Feng Chen, Jing Li, Ling-Long Xu, Mihnea-Alexandru Găman, Zhen-You Zou
Yong-Feng Chen, Department of Basic Medical Sciences, School of Medicine of Taizhou University, Taizhou University, Taizhou 318000, Zhejiang Province, China
Jing Li, Department of Histology and Embryology, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Ling-Long Xu, Department of Hematology, Taizhou Central Hospital, Taizhou 318000, Zhejiang Province, China
Mihnea-Alexandru Găman, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest 050474, Romania
Zhen-You Zou, Department of Scientific Research,Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China
Author contributions: Chen YF and Li J contributed to conceptualization and original draft preparation, prepared figures, and contributed equally to this work; Xu LL, Zou ZY, and Găman MA contributed to reviewing and editing; Chen YF and Găman MA contributed to supervision; All authors have read and agreed to the published version of the manuscript; Găman MA and Zou ZY contributed equally to this work as senior/last authors.
Supported by the Scientific Research Project of the Sichuan Province Education Department, No. 16ZA0241; the National Natural Science Foundation of China, No. 82060268; and the Guangxi Natural Science Foundation of China, No. 2020JJA140124.
Conflict-of-interest statement: All authors declare having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mihnea-Alexandru Găman, MD, PhD(c), Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest 050474, Romania. mihneagaman@yahoo.com
Received: October 10, 2022
Peer-review started: October 10, 2022
First decision: November 16, 2022
Accepted: January 5, 2023
Article in press: January 5, 2023
Published online: January 16, 2023
Processing time: 93 Days and 12.5 Hours
Abstract

As an important treatment for acute myeloid leukemia, allogeneic hematopoietic stem cell transplantation (allo-HSCT) plays an important role in reducing relapse and improving long-term survival. With rapid advancements in basic research in molecular biology and immunology and with deepening understanding of the biological characteristics of hematopoietic stem cells, allo-HSCT has been widely applied in clinical practice. During allo-HSCT, preconditioning, the donor, and the source of stem cells can be tailored to the patient’s conditions, greatly broadening the indications for HSCT, with clear survival benefits. However, the risks associated with allo-HSCT remain high, i.e. hematopoietic reconstitution failure, delayed immune reconstitution, graft-versus-host disease, and post-transplant relapse, which are bottlenecks for further improvements in allo-HSCT efficacy and have become hot topics in the field of HSCT. Other bottlenecks recognized in the current treatment of individuals diagnosed with acute myeloid leukemia and subjected to allo-HSCT include the selection of the most appropriate conditioning regimen and post-transplantation management. In this paper, we reviewed the progress of relevant research regarding these aspects.

Keywords: Hematopoietic stem cell; Transplantation; Allogeneic hematopoietic stem cell transplantation; Leukemia; Treatment

Core Tip: Allogeneic stem cell transplantation remains an important player in the therapeutic armamentarium of acute myeloid leukemia. However, this procedure has its advantages and disadvantages. In this narrative review, we explore the obstacles and opportunities of allogeneic stem cell transplantation in acute myeloid leukemia as well as the recent advances in the field.