Patient Eligibility for Transplant, Induction, and Consolidation in AML Treatment

Patients with newly diagnosed acute myeloid leukemia (AML) undergo transplant evaluation as part of their comprehensive treatment planning, with decisions based on disease risk factors, overall health status, and treatment goals rather than age alone. Health care teams now initiate transplant consultations within the first month of treatment for intermediate and high-risk patients, recognizing that modern transplant techniques and improved supportive care have expanded eligibility criteria. Patients who previously would have been excluded due to age or comorbidities may now be candidates through reduced-intensity conditioning regimens and better graft-vs-host disease prevention strategies.

The treatment approach has evolved to preserve patients’ organ function for potential transplantation rather than pursuing the most intensive therapy possible upfront. Patients receiving lower-intensity regimens like azacitidine with venetoclax may actually become better transplant candidates by avoiding the cardiac, liver, or kidney damage that can result from intensive chemotherapy. This shift means that achieving remission while maintaining fitness for transplant takes priority over the historical approach of maximum-intensity induction therapy for all eligible patients.

Even patients with favorable-risk disease may receive transplant consultations as a precautionary measure, ensuring rapid access to transplant services should their disease prove more challenging than initially expected. The timeline for transplant has accelerated, with many patients proceeding to transplant within 6 to 8 weeks of achieving remission rather than completing multiple consolidation cycles. Modern donor matching techniques, including haploidentical transplants and improved unrelated donor registries, have reduced the barrier of finding suitable donors, making transplantation a realistic option for more patients than ever before.