Cardio-oncology and transplantation for acute myeloid leukemia

Acute Myeloid Leukemia (AML) includes a spectrum of aggressive hematologic malignancies with considerable heterogeneity in biology and treatment responsiveness, and while the treatment landscape continues to rapidly evolve, allogeneic hematopoietic cell transplantation (allo-HCT) remains the only potentially curative treatment option for many high-risk AML patients [1]. Advances to transplantation techniques to reduce risk of disease relapse and graft-versus-host disease (GVHD), improvements in supportive care, use of haploidentical donors, and transplanting older patients have all resulted in the continued growth of patients undergoing allo-HCT with marked reduction in treatment-related mortality [2,3]. Cardiovascular disease (CVD; heart failure, myocardial infarction, stroke) remains an important competing risk before, during, and long after allo-HCT necessitating the development of cardio-oncology programs to provide multidisciplinary cardiovascular care of cancer patients with a focus on optimizing cardiovascular health and close monitoring of potential treatment related cardiotoxicities across the cancer care continuum [4,5]. The present review provides a concise and practical approach to cardio-oncology considerations for allo-HCT in AML.

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