Modern indications for stem cell transplantation in primary diagnosed pediatric acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) in children and adolescents is one of high curable malignancy with long-term survival rate 91 %. Nevertheless, patients with high risk of relapse / refractory ALL have event-free survival not exceed 55 %. For therapeutic efficacy improvement in patients with high risk ALL, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is used. Improvement of ALL therapy by targeted and molecular oriented drugs (imatinib mesylate, dasatinib, blinatumomab, inotuzumab ozogamycin), extension of therapeutic options for patient care in the post-transplant period are changed indications for allo-HSCT. In the current issue a modern indications for allo-HSCT in patients with primary diagnosed ALL, based on cytogenetic, molecular biologic, and clinical characteristics by the leading research groups AIEOP / BFM (Italy / Germany), St. Jude (USA), COG (USA) are presented. In spite of presented differences, common indications for allo-HSCT are minimal residual disease persistence in postinduction period in combination with cytogenetic, molecular and biologic factors of unfavorable prognosis.