Transplant Referral Timing Guidelines

HCT consultation should take place early after initial diagnosis, for all patients with AML including:

• Primary induction failure
• Measurable (also known as minimal residual disease after initial therapy
• CR1 - except favorable risk AML [defined as:t(8;21)(q22;q22.1); RUNX1-RUNX1T1, inv(16)(p13.1q22) or t(16;16)(p13.1;q22);CBFB-MYH11, mutated NPM1 without FLT3- ITD, biallelic mutated. Early referral for allogeneic HCT should also be considered any AML patient in CR1 who are 60-years or older; regardless of cytogenetic or genomic information.
• Antecedent hematological disease (e.g., myelodysplastic syndromes (MDS))
• Treatment-related leukemia
• First relapse
• CR2 and beyond, if not previously evaluated.

Early after initial diagnosis, all patients with AML including:
• Age < 2 years at diagnosis
• Primary induction failure
• Minimal residual disease after initial therapy
• CR1 — except favorable risk AML [defined as:t(8;21)(q22;q22.1); RUNX1- RUNX1T1, inv(16)(p13.1q22) or t(16;16)(p13.1;q22);CBFB-MYH11, mutated NPM1 without FLT3-ITD or with FLT3-ITDlow, biallelic mutated CEBPA]
• Monosomy 5 or 7
• Treatment-related leukemia
• First relapse
• CR2 and beyond, if not previously evaluated