Allogeneic stem cell transplantation
Replacing a patient's blood system with a donor's, so the donor's immune cells hunt down any leukaemia left behind. Still the only cure for many high-risk leukaemias.
Conditioning chemotherapy (myeloablative or reduced-intensity) followed by donor stem cells. The graft-versus-leukaemia effect provides ongoing immune surveillance; graft-versus-host disease is the price. Indicated in ELN adverse-risk AML in first remission, intermediate-risk with MRD positivity, relapsed disease, high-risk ALL, and Richter transformation. Post-transplant cyclophosphamide has made haploidentical donors routine; post-transplant maintenance (FLT3 inhibitors, azacitidine, menin inhibitors in trials) is reducing relapse.
How it works
Myeloablation eradicates host haematopoiesis; donor T cells recognise residual leukaemia via minor histocompatibility antigens.
- Curative for otherwise incurable leukaemia
- Graft-versus-leukaemia is an antigen-agnostic immune therapy
- Treatment-related mortality 10-20%
- Chronic GVHD
- Relapse remains the main cause of failure
Belumosudil is a pill for chronic graft-versus-host disease, the long-term immune complication of donor stem-cell transplants used to cure blood cancers.
One of the most widely used chemotherapy drugs: part of CHOP for lymphoma, AC for breast cancer, VAC for childhood sarcomas, and used to prepare patients for CAR-T and transplant.
Ruxolitinib was the first JAK inhibitor: it shrinks the spleen and relieves symptoms in myelofibrosis and controls blood counts in polycythaemia vera, without eliminating the disease clone.
A conditioning chemotherapy given before donor stem-cell transplant in AML and MDS; it was long used in Europe and reached the US in 2025.
QuANTUM-First gave FLT3-ITD AML patients a second front-line targeted option and showed that continuing a FLT3 inhibitor as long-term maintenance, including after transplant, pays off. Quizartinib was approved for this indication in 2023. Head-to-head data against midostaurin are lacking, and the design leaves open how much of the benefit came from maintenance.
ADMIRAL showed that a targeted oral drug can beat chemotherapy outright in relapsed AML, and made gilteritinib the standard bridge to transplant for FLT3-mutated relapse. Its success also underpinned FLT3 inhibitor use in first-line combinations. Resistance through FLT3-independent clones and RAS pathway mutations limits durability without transplant.
INO-VATE made inotuzumab a standard salvage therapy for adult ALL and a common route to transplant, and, with the TOWER trial of blinatumomab, moved adult ALL from chemotherapy-only salvage to immunotherapy. Both drugs have since been pulled into front-line regimens. The liver toxicity signal shaped how transplant conditioning is chosen after inotuzumab.
Latest papers
topQuery for this technology: (TITLE:"Allogeneic stem cell transplantation" OR ABSTRACT:"Allogeneic stem cell transplantation") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Allogeneic stem cell transplantation, not a curated reading list.
Pages like this
not linked directly; found by shared links- TechnologyNGS-based MRD (clonoSEQ and molecular MRD)
Shares MRD-guided transplant decisions in intermediate-risk AML, Transplant-free Ph-positive ALL for MRD-negative adults, MRD-negative complete remission, Myeloproliferative neoplasms (PV, ET, myelofibrosis).
- CollectionLeukemia & Lymphoma Society (LLS)
Shares Myeloproliferative neoplasms (PV, ET, myelofibrosis), Chronic myeloid leukaemia (CML), Mantle cell lymphoma, Myelodysplastic syndromes / neoplasms (MDS).
- TechnologyCytogenetics and FISH
Shares ELN 2022 risk classification, Chronic myeloid leukaemia (CML), Myelodysplastic syndromes / neoplasms (MDS), Chronic lymphocytic leukaemia.
- TechnologyMultiparameter flow cytometry MRD
Shares MRD-negative complete remission, Myelodysplastic syndromes / neoplasms (MDS), Chronic lymphocytic leukaemia, MRD / molecular residual disease testing.
- ProductInotuzumab ozogamicin
Shares Caution: inotuzumab before transplant (veno-occlusive disease), INO-VATE: inotuzumab ozogamicin, a CD22 antibody-drug conjugate, versus chemotherapy for relapsed adult B-cell ALL, Acute lymphoblastic leukaemia.
- TargetFLT3
Shares ADMIRAL: gilteritinib pills versus chemotherapy for relapsed FLT3-mutated acute myeloid leukaemia, ELN 2022 risk classification, QuANTUM-First: quizartinib added to intensive chemotherapy and continued as maintenance in newly diagnosed FLT3-ITD AML, Acute myeloid leukaemia.
- Key paperMaude 2014: CD19 CAR-T cells produce complete remission in 27 of 30 children and adults with relapsed ALL
Shares David L. Porter, MRD-negative complete remission, Chronic lymphocytic leukaemia, Acute lymphoblastic leukaemia.
- PersonHagop M. Kantarjian
Shares INO-VATE: inotuzumab ozogamicin, a CD22 antibody-drug conjugate, versus chemotherapy for relapsed adult B-cell ALL, Chronic lymphocytic leukaemia, Acute lymphoblastic leukaemia, Acute myeloid leukaemia.