Risk-adapted MRD-directed therapy for young adults with acute myeloid leukemia: 6-year update of the GIMEMA AML1310 trial

Intensive chemotherapy followed by allogeneic stem cell transplantation (ASCT) remains the mainstay for the treatment of fit patients with de novo acute myeloid leukemia (AML) aged <60 years.1,2 For patients who achieve remission with induction, appropriate selection of postremission therapy (including ASCT) using tools such as the European LeukemiaNet (ELN) risk stratification is essential to determine the patients’ risk of relapse and ASCT candidacy,1 to balance treatment-related mortality (primarily associated with ASCT), and the risk of relapse itself. Patients with a favorable genetic/cytogenetic profile are generally offered postconsolidation chemotherapy, whereas patients with adverse characteristics are offered ASCT. For those in the intermediate category, no consensus exists about the optimal postremission therapy.