When is allogeneic stem cell transplant recommended for acute myeloid leukaemia?

Acute myeloid leukaemia can return even after blood and marrow tests show remission. A donor transplant replaces the blood-forming system after conditioning treatment, and donor immune cells may help attack remaining leukaemia cells. The team reviews chromosome and gene findings, measurable residual disease, the response to induction and consolidation treatment, previous relapse, age, organ function, infections, and donor compatibility. Some people proceed in first remission when relapse risk is high; others are referred after resistant or recurrent disease.

Ask which test results define your remission and whether residual disease can be detected. A transplant work-up may include donor typing, blood tests, heart and lung assessments, infection checks, dental care, and fertility discussion. Make a medicine list and identify a caregiver who can help with transport and daily monitoring. Do not start supplements or stop prescribed treatment without checking with the haematology team.

Seek urgent advice for fever, chills, new breathing difficulty, chest pain, confusion, bleeding that does not stop, severe abdominal symptoms, or very little urine. After transplant, a new rash, yellowing skin, worsening diarrhoea, or painful mouth ulcers also requires prompt contact. Reduced immunity can make infection and treatment complications progress rapidly.

Ask how my genetic findings and residual disease affect relapse risk, whether transplant is advised in remission, what donor options exist, which complications are most relevant to me, and how follow-up will be organised.