Timing for HCT Consultation

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Presentation transcript:

Timing for HCT Consultation 9/9/2019 Timing for HCT Consultation Acute Myeloid Leukemia (AML) - Adult High-resolution HLA typing is recommended at diagnosis for all patients Early after initial diagnosis, all patients with AML including: Primary induction failure Minimal residual disease after initial therapy CR1 – except favorable risk AML [defined as: t(16;16), inv16, or t(8;21) without c--KIT mutation; t(15;17); normal cytogenetics with NPM1 or isolated biallelic CEBPA mutation and without FLT3-ITD] Antecedent hematological disease (e.g., myelodysplastic syndromes (MDS)) Treatment-related leukemia First relapse CR2 and beyond, if not previously evaluated These guidelines identify appropriate timing of consultation for autologous or allogeneic hematopoietic cell transplantation (HCT) based on disease characteristics. Evaluation and coordination of the timing of HCT for eligible patients is determined in collaboration with the transplant center. In many situations, early referral is a critical factor for optimal transplant outcomes. Likewise, delays in referral can reduce success rates for transplant because there may be a narrow window of opportunity to proceed to transplant and delays might preclude transplant altogether. Research data comparing outcomes by disease status can be found at BeTheMatchClinical.org/HCTtiming. If allogeneic transplant is a possibility, HLA typing of the patient (high resolution) and potential family donors should be completed at time of diagnosis, and if no matches are found, a preliminary unrelated donor search of the Be The Match Registry® should be done. These 2019 guidelines were developed jointly by the National Marrow Donor Program® (NMDP)/Be The Match® and the American Society for Blood and Marrow Transplantation (ASBMT) and are based on current clinical practice, medical literature, National Comprehensive Cancer Network® (NCCN®) Guidelines for the treatment of cancer and evidence-based reviews. SOURCE: NMDP/Be The Match & ASBMT Recommended Timing for Transplant Consultation.