Prerpints.org logo
Preprint
Review

This version is not peer-reviewed.

Role of Autologous Haemopoietic Transplantation in Leukemias, When to Consider It, 2026

Submitted:

15 April 2026

Posted:

17 April 2026

You are already at the latest version

Abstract
This review aims to provide comprehensive and practical information on the once-nearly-forgotten but now resurgent roles and trends of autologous transplantation in leukemias. We seek to categorize when it is necessary as a first-line treatment (plasma cell leukemia) and to identify well-defined patient subgroups (such as certain types with intermediate prognosis in AML, APL second remission, etc.) in which autologous transplantation might be comparably or even slightly more effective than allogeneic transplantation, not only in frail patients. In some leukemias, such as CLL, autologous transplantation still does not play a role. Attempts to achieve anti-leukaemic effects in autologous settings have proven largely ineffective, but new approaches might be promising. Newer cell therapies (such as CAR-T) are significantly more effective, and the same applies to in vitro graft purging. However, this area has been investigated relatively recently in an innovative manner, using specific graft pretreatments that may also stimulate anti-leukemic immune responses in autologous cases.
Keywords: 
autologous transplantation
;  
acute myeloid leukemia
;  
plasma cell leukemia
;  
innovative approaches to improve results in autologous settings
Subject: 
Medicine and Pharmacology  -   Hematology

Introduction

History

Decades ago, mainly due to Gorin’s, Burnett’s and Stuart’s [1,2] excellent approaches and efforts, autologous stem cell transplantation was considered a powerful alternative to allogeneic transplantation modalities in AML (sometimes instead of post-induction (cytosine arabinoside type therapies). This concept was supported primarily because of the limited availability of compatible donors at the time, also due to the higher early transplant-related mortality associated with allogeneic procedures during that period, and the costs of post-induction therapies for acute leukemias [3].
There were special early recommendations regarding AML autologous transplantation, including conditioning (firstly TBI-cyclophosphamide, later Flu-Mel, and, later, Bu-Mel, etc.) and the timing of the autologous transplant, not too early (later, this concept changed a lot) after post-induction treatment [1,2,4]. Donor availability issues improved significantly with umbilical cord methods and even more with haploidentical donor practice. So the remaining points in autologous transplantation were, later on, reduced early transplant-related mortality and some very high-risk biological condition patients.
Some factors that led to the dominance of allogeneic transplants following the initial wave of autotransplantation for leukemia are as follows:
  • Anyway, it became clear that autologous transplant mortality is significantly higher in leukemic patients compared to those with myeloma or lymphoma undergoing autologous transplantation. Autologous transplantation in acute leukaemia, depending on condition and modality, may carry a higher risk of early mortality, about 5-10%, than in myeloma or lymphoma [4].
  • b. So the age limit is higher, but frailty might also be an issue in autologous settings. In the meantime, mortality from early allogeneic transplantation has improved significantly [5,6].
  • c. Donor availability was a much more critical issue decades ago, but umbilical cord, haploidentical transplant, etc., provide much better donor finding possibilities [7]
  • d. Induction of GVL in autologous settings was not achieved (e.g., IL-2, cyclosporin A, etc.). However, some older methods, with improved technologies, have led to more recent efforts still aiming to achieve it [8,9,10]. More recently, magnetic sorting of CD96 cells, in vitro pulsing with an oncolytic virus, and, quite recently, the addition of a PD-1 blocker, as well as NK cell activation efforts, are promising approaches to achieve this goal. PD-1 blockade may enhance GVL and has been tried (pembrolizumab) for maintenance following autologous AML transplants. However, the many side effects of PD-1 ligand administration, including potential reductions or alterations in platelet counts and increased thrombotic risk, should also be considered when making decisions [11,12,13]. Nevertheless, more clinical experience is still needed to evaluate these approaches in real-life settings.
  • e. Purging of autologous stem cell graft in vivo by combining cytosin arabinosid with etoposide might also be an interesting approach. In vitro purging was not a reliable approach for many years. Interestingly, some recent efforts in high-tech screening are promising, even though they are far from clinical evaluation [14].
  • f. A potential drawback of autologous transplantation might be the development of clonal hemopoiesis, like in myeloma or lymphoma cases, along with myelodysplastic, etc. [15,16]
  • g. Autologous transplantation is not entirely free from thrombotic microangiopathy (TMA) and veno-occlusive disorders, but the incidence of these complications is considerably lower than in allogeneic settings. TMA is less frequent than in allogeneic contexts, except when high-dose platinum is used during conditioning treatment. Significantly fewer cases of VOD are reported following autologous transplant, probably <5% [5,14].
  • h. Iron overload (mainly in multitransfused myelodysplasia or myelofibrosis patients) hurts stem cell harvesting [17]
  • i. For the vast majority of patients, allogeneic transplantation, with its anti-leukaemic action, was and still is by far the best choice for cure or survival improvement. The autologous route was almost completely forgotten [14]

More Recent Concepts to Reevaluate Autologous Transplants in Leukemias

Over the past few years, due to the modernization of AML classification and new concepts regarding allo-transplant timing to achieve MRD negativity, the approach to autologous transplants in acute leukemias has been revisited. There is very strong evidence that, in acute leukemia, the timing of allogeneic transplantation is the most critical factor in attaining deep molecular remission (not only clinical or cytogenetic remission). A predictive model based on MRD burden has been developed, identifying a threshold of 0.05% MRD; patients with levels below this threshold have a significantly lower risk of relapse, with a 4.6-fold reduction in relative risk. This raises the question: how does leukemia autologous transplantation work? What are the results? If stem cell harvesting occurs during this profound MRD/molecular remission period, does it influence the relapse rate across different leukemia types and subsets [4,6,14] ?
Perhaps the indication for autologous transplantation is not limited to elderly, frail patients (or those without a donor) but also applies to certain other types or subsets of acute leukemias [18]. The availability of alternative stem cell sources, including most recently T-replete haploidentical marrow or peripheral blood, as well as the increasing use of reduced-intensity conditioning (RIC), makes allogeneic transplants feasible for nearly all patients with acute leukemia up to the age of 70. Autologous stem cell transplantation (ASCT) to consolidate complete remission (CR) offers an alternative in specific circumstances. Despite its association with a higher relapse rate, autologous transplantation offers benefits such as lower non-relapse mortality, hospitalisation time, absence of graft-versus-host disease (GVHD), and improved long-term quality of life. The recent use of intravenous busulfan (IVBU) combined with high-dose melphalan, along with enhanced monitoring of minimal residual disease (MRD) and maintenance therapy after autografting, has generated renewed interest [6,14,19].
On the other hand, several innovative purging strategies have been explored. One approach involves positive selection of normal hematopoietic stem cells using CD34 and/or CD133 markers. This method can be safely and effectively used in 50% of AML cases, as indicated by the absence or low expression of these markers at diagnosis, which remains stable at relapse. This technique achieves a 3-4 log reduction in tumour cells while maintaining a median recovery of 50% of normal stem cells. Otaroundher methods include ex vivo purging with oncolytic viruses such as myxoma virus (MYXV), which selectively eliminate cancerous stem and progenitor cells from AML patient samples while sparing normal CD34+ hematopoietic stem and progenitor cells capable of restoring haematopoiesis. Magnetic-activated cell sorting with antibodies targeting AML-specific antigens, such as CD96, has also shown promise, achieving over a 2-log depletion of target cells without impairing the viability or differentiation potential of healthy haematopoietic progenitor cells.
In vivo purging strategies, such as administering early intensification therapy with high-dose cytarabine and etoposide before stem cell collection, have demonstrated a significant reduction in relapse risk, with disease-free survival rates of 68.8% compared to 35.5% in patients not receiving this treatment. Additionally, combinations of cryopreservation, hyperthermia, and the ether lipid ET-18-OCH3 have been shown to achieve at least a 1-log depletion of AML blasts. Stem cell processing technologies, along with microbiome optimisation settings, and Wilms tumour gene 1 (WT-1) vaccination, have led to promising antileukaemic immunoreactivity, even in some autologous settings [12]. The choice of purging method often depends on the patient’s specific disease characteristics, including MRD levels and antigen expression profiles and probably some microbiome modifications may also improve results [13,20,21].
Immunological interventions raise the hope of creating some GVL-like antileukemic effect with interferon, or induced stem cell origin NK cells [22,23].
Stem cell processing technologies may utilize new approaches to modify the immunoreactive cell composition of the harvested graft in ways that might promote antileukaemic immunoreactivity, even in some autologous settings [24].
So, considering all this, we aim to review the leukaemic conditions in which autologous transplantation must be the first step, or a powerful option like some well-defined leukaemic subgroups in which it might be slightly better than first-line allogeneic transplantation, and some other situations in which it should be considered a valuable alternative to allogeneic transplantation, especially with maintenance settings.
Provoking GVL following autologous transplantation, which had not been achieved for decades despite various, ultimately unsuccessful efforts, received renewed attention. A good example is the use of manoeuvres to activate NK cells, as well as the administration of PD-1 inhibitors in the post-transplant phase [13].
More recently, after better identification of patients in really complete molecular remission, some subgroups of acute leukemia patients were increasingly identified as benefiting equally or even slightly more with an autologous approach, opening doors for frailty patients, where transplantation modality could also be combined with maintenance modalities, and, in the end, the survival might be better or equivalent to allogeneic transplantation.). So, considering all this, we aim to review the leukaemic conditions in which autologous transplantation must be the first step, or a powerful option like some well-defined leukaemic subgroups in which it might be slightly better than first-line allogeneic transplantation, and some other situations in which it should be considered a valuable alternative to allogeneic transplantation, especially with maintenance settings. Innovative purging and GVL-provoking efforts may further shape allogeneic versus autologous transplant decisions, likely in the near future.
Clinical areas and indications for autologous transplantation and leukemias
General considerations: There is virtually no theoretical upper age limit for autologous transplantation in acute leukemias. However, frailty can be independent of chronological age, which may limit indications.
Stem cell harvesting might also be necessary if allogeneic transplantation is the chosen treatment, and may serve as a bridging option in the event of graft failure to obtain a new donor and stem cells. Clearly, in some cases, if allogeneic transplantation is performed near the upper age/biological limit, relapse may be treated as an option among others with an autologous transplant.

Indications

Plasmacytic Leukemia, Autologous Transplantation

Plasmacytic leukemia is a strong indication for first-line autologous transplantation, practically a must. More recent data show that allo-transplant in this condition does not offer any benefit compared to autologous transplantation. Maintenance should follow the intervention tn the standard way [25,26,27,28].

Chronic Lymphocytic Leukemia (CLL)

Autologous transplantation in CLL carries a high mortality risk as opposed to myeloma or other lymphomas. There are powerful new medical treatments that attain deep remissions and improve survival, so it seems really outdated, except for very special, well-defined conditions, such as Richter transformation in CLL [29,30,31].

Acute Myeloid Leukemia (AML)

Few retrospective studies have compared outcomes following alternative donor versus autologous transplants for remission consolidation. Geno-identical and pheno-identical allogeneic stem cell transplantations are undisputed gold standards.
The availability of alternative stem cell sources, including, most recently, T-cell-replete haploidentical marrow or peripheral blood, along with the increasing use of reduced-intensity conditioning, makes allogeneic transplants feasible for nearly all patients with acute leukemia up to the age of 70. Autologous stem cell transplantation to consolidate complete remission provides, in certain cases, an alternative. However, although it is associated with a higher relapse rate, autologous transplantation features lower non-relapse mortality, no risk of graft-versus-host disease (GVHD), and an improved quality of life for long-term survivors.
Extensive studies have recently been conducted to identify well-defined subsets of AML patients who benefit from autologous transplants, with outcomes that are comparable or even slightly better. In these subgroup analyses, an important initial criterion is the presence of a deep, MRD-negative first remission.
There is still evidence that poor-prognosis AML transplant remains undoubtedly an allogeneic intervention [14]. So, mainly the intermediary prognostic category moved into the focus of revisiting allogeneic/versus autologous transplant modalities [14].
Favourable risk AML, both autologous and allogeneic, had a 5-year relapse-free survival rate in the 60% range [14,32,33]. In the intermediate, non-selected group, 5-year survival was about 20% higher, mainly due to a larger proportion of relapse (20% range) in autologous settings [34]. However, Yoons et al.’s data were also clear that in the intermediate prognostic group of AML, with favourable (or no) molecular alterations, the 5-year OS was 84%, which was better than with allogeneic transplantation [34].
Intermediate-risk cytogenetics with favourable molecular risk, whether using autologous or allogeneic procedures, was associated with similar overall survival: 62% versus 66%. This provides a valid, less toxic option [30,33]. As more data are collected or published, molecular subtypes of intermediate-risk AML may become potential candidates for autologous transplantation [30].
Intermediate-risk cases with good MRD (including RUNX- -RUNX1T1, i.e t8:21 quantitation, differential evaluation of IDH1 and IDH2 in MRD assessment) and no flt-1 mutation had results comparable to haplo allo patients, whereas haplo allo is better in intermediate-risk cases with flt-3 mutations. The role of anti-flt medications following auto is still unclear. The Pethema group published a large patient group analysis showing that patients with no cytogenetic alterations and no Flt-ITD mutation had better response rates and survival with autologous than allogeneic transplantation, and they consider autologous transplantation still an alternative for selected AML patients, achieving best results in MPN-1 mutated flt-3 ITD negative cases [35]. Other data also indicate that, in the intermediate prognostic group, AML autologous transplant patients with Flt3 wild-type fared better than those who received haploidentical allogeneic transplantation. However, Flt-3-positive cases had significantly worse outcomes with autologous transplants [36].
The Spanish multicenter trial compared 2 subgroups with intermediate-risk cytogenetics.
AML patients: a combined with favourable cytogenetics (mutated NPM1, CEBPA biallelic mutation) or with unfavourable molecular condition (NPM1 non-mutated, flt-3 ITD mutation). It became clear that the favourable molecular subgroup autologous result was comparable to allogeneic transplantation (5-year OS 77% versus 70%). Still, in the unfavourable molecular subgroup, 5-year OS was available for only 40% of patients; in this cohort, allogeneic remains the standard mode of transplantation [35].
Sula et al. in core-binding factor-positive AML cases had excellent results with the autologous approach, with CBF usually disrupted in 16/21, resulting in a relatively good prognosis even without transplant, but relapse remains an issue. In patients with FLT3 mutations, the haplo type confers better survival [36].
While allogeneic transplantation (using donor cells) remains the preferred option for high-risk patients, auto-HSCT is a valuable alternative for intermediate- or favourable-risk patients (molecular approach), especially when a matched donor is unavailable [37]. In cases of AML second relapse, the recommendation is repeated allogeneic transplantation, not autologous transplantation [38].
Maintenance therapy after autologous transplant has been studied, and the use of sorafenib has been clearly proven to be beneficial. Also, there are data on azacytidine and giltertinib use in flt3-positive cases. However, this data is the allogeneic setting, and has not been investigated after autologous transplantation. It is very likely that the us of maintenance should be incorporated into the treatment plan after autologous transplantation, as well[14,30,37].

Acute Promyelocytic Leukemia (APL)

Due to the effectiveness of first-line retinoic acid and arsenic-based therapies, bone marrow transplantation has a very limited role in treatment. Refractory or first-relapse cases should receive allogeneic transplantation (there is no role for autologous). Still, after a PML-RARA-negative PCR result, a stem cell graft might be used in patients with limited biological resources to prevent further relapse. However, new data are very promising, including a large retrospective analysis of 294 patients showing that autologous transplantation yields superior overall survival compared with allogeneic transplanted APL patients in second complete remission. Five-year OS was 75% for autologous versus 54% for allogeneic, primarily due to significantly lower treatment-related mortality i.e., 2% versus 30% [39]. These findings are part of extensive international guidelines (involving childhood), in a second relapse if stem cells were harvested during complete molecular remission. [40,41,42,43,44]

AML, In Summary

While allogeneic transplantation remains superior for high-risk patients, autologous transplantation is a valuable alternative for intermediate- or favourable-risk patients, especially when a matched donor is unavailable. It is generally not recommended for poor-risk cytogenetics. In well-defined subgroups, results are competitive with or better than those of allogeneic transplantation. Good-prognosis AML cases and intermediate-risk (without cytogenetic alterations) cases in first MRD-negative remission may benefit from allogeneic (haplo) transplants or achieve better outcomes. CBF and CEBPA results should also be considered in decision-making, as some data indicate efficiency in the 2nd CR as well [45]. Promyelocytic leukemia second relapse shows better results with an autologous transplant compared to an allogeneic one.

ALL

Autologous stem cell transplantation (ASCT) is rarely used as a primary treatment for adult acute lymphoblastic leukemia (ALL), especially in standard-risk patients, because it is less effective than conventional consolidation and maintenance chemotherapy. In the final results of the International ALL Trial (MRC UKALL XII/ECOG E2993) [47], patients assigned to autologous transplantation had a lower 5-year overall survival (OS) of 37% compared to 46% in those receiving chemotherapy [46]. The greatest survival benefit in standard-risk ALL is achieved with matched sibling allogeneic transplantation in first complete remission. There are many powerful innovations in ALL treatment standards, including specific immune and cell therapies. In summary, while autologous transplantation is not the preferred option for most adult ALL patients, it can serve as a viable alternative when a matched donor is unavailable, particularly in patients with favourable risk features and minimal residual disease negativity. The decision must weigh the higher relapse risk associated with autologous transplants against the increased transplant-related mortality linked to allogeneic transplants. Several recent multicentre trials have considered autologous transplantation a good option in the late phase of Philadelphia-negative Precursor T-Cell ALL [47]. Giebel et al. describe non-prospective data on autologous. transplantation in Philadelphia-negative ALL, over the age limit of 55 years, and concluding as an alternative approach with some benefit [48].

CML

Primary intention autologous transplantation is not indicated in CML (there are excellent drugs), chronic neurophilic leukemia, or atypical CML. Basically, CML, for the time being, is becoming less and less a transplant indication; if so, it should be allogeneic. Autologous transplantation might be extremely rare and, except for elderly and very frail patients, would usually result in shorter remission [49,50].

Discussion

Autologous transplantation in leukemia was a recommended option 20-30 years ago, mainly due to issues with donor availability, age restrictions, and biological conditions, along with better early post-transplant mortality rates. Over time, practices have evolved as new donor sources and haploidentical transplants have emerged, and early post-allogeneic mortality has improved, however early autologous mortality in leukemia still exceeds that in myeloma or lymphoma autografting. Undoubtedly, TMA and VOD are less common in autologous settings. Traditional approaches, such as in vivo or in vitro stem cell purging or the induction of anti-leukaemic immune responses, have long failed. It is also clear that secondary MDS and clonal haematopoiesis can occur after some or a few autotransplants, so it remained an option for quite old and frail patients. Otherwise, allogeneic transplants show clearly better results, with fewer relapses due to GVL.
This rather disappointing opinion started to change in some respects. New in vitro cell selection/pugging approaches have been developed (awaiting large trials). NK cell activation and administration of PD-1 inhibitors might elicit a more or less pronounced antileukemic immune response; we are still awaiting clinical proof.
Even more importantly, it is clear that some in special conditions mean an obligation to start with an autologous transplant, like plasma cell myeloma with plasma cell leukemia, or acute promyelocytic leukemia in 2nd relapse (if molecular remission graft is available) Even more importantly some subgroups of acute myeloid leukemia, mainly intermediary prognostic cases, and precursory T cell subset of ALL results are slightly better with the autologous approach. They should be screened later on clonal hemopoiesis and MDS, too.
Of course, the donor availability problems (if they are really present) and age/biological condition are still moving things toward autologous transplant.
Nevertheless, no data demonstrate the superiority of alternative allogeneic donor over autologous transplantation at the time of undetectable MRD in patients with good- and intermediate-1-risk acute myeloid leukemia (AML), especially with favourable molecular alterations, in first complete remission, and in acute promyelocytic leukemia in second complete remission.

Author Contributions

MU: transplanter, first and foremost, prompted author; LG, RS, LIP: transplant team members performing transplantations in acute leukemias; GR: the main person in charge of covering letter our acute leukemia division, participates also in transplantation; AI: coordinates and supervises the hematological work at our Department and also in the Transplant Unit, head of the Department.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Data Availability Statement

No new data were created or analyzed in this study.

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
  • Arhgef: Rho Guanine Exchange Factor, cytokine modification for GVL in transplant modalities
  • AML: acute myeloid leukemia
  • ALL: acute lymphoid leukemia
  • APL: acute promyelocytic leukemia
  • ASCT: autologous stem cell transplantation
  • CBF: core binding factor
  • CEBPA: CCAAT/enhancer-binding protein
  • CLL: chronic lymphoid leukemia
  • CML: chronic myeloid leukemia
  • CR1, CR2: first, second complete remission
  • ET-18-OHC3: edelfosine cell-permeable, reversible cytotoxic agent
  • FLU: fludarabine
  • GVHD: graft versus host disease
  • GVL: graft versus leukemia effect
  • IL-2: interleukin 2
  • PD1-L: programmed cell death ligand 1
  • IRn: irinothecan type treatment
  • MDS: myelodysplastic syndrome
  • MEL: meplhalane
  • MRD: minimal residual disease
  • OS: overall survival
  • TBI: Total Body Irradiation
  • TMA: thrombotic microangiopathy
  • TRM: transplant-related mortality
  • VOD (SOS): Veno-Occlusive Disease (VOD), also called Sinusoidal Obstruction Syndrome (SOS)
  • WT-1: Wilms tumour gene 1

References

  1. Claude Gorin N. Autologous stem cell transplantation versus alternative allogeneic donor transplants in adult acute leukemias. Semin Hematol. 2016 Apr;53(2):103-10. Epub 2016 Jan 19. PMID: 2700073. [CrossRef]
  2. Burnett AK, Goldstone AH, Stevens RM, Hann IM, Rees JK, Gray RG, Wheatley K. Randomised comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukemia in first remission: Results of MRC AML 10 trial. UK Medical Research Council Adult and Children’s Leukemia Working Parties. Lancet. 1998 Mar 7;351(9104):700-8. PMID: 9504514. [CrossRef]
  3. Stuart RK. Autologous bone marrow transplantation for leukemia. Semin Oncol. 1993 Oct;20(5 Suppl 6):40-54. PMID: 8211215.
  4. Santos GW. Bone marrow transplantation: Current results in leukemia. Yale J Biol Med. 1982 Sep-Dec;55(5-6):477-85. PMID: 6763816; PMCID: PMC2596566.
  5. Corbacioglu S, Jabbour EJ, Mohty M. Risk Factors for Development of and Progression of Hepatic Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome. Biol Blood Marrow Transplant. 2019 Jul;25(7):1271-1280. Epub 2019 Feb 22. PMID: 30797942),History revival. [CrossRef]
  6. Gorin NC. History and Development of Autologous Stem Cell Transplantation for Acute Myeloid Leukemia. Clin Hematol Int. 2021 Jul 15;3(3):83-95. PMID: 34820613; PMCID: PMC8486970. [CrossRef]
  7. Sweeney C, Vyas P. The Graft-Versus-Leukemia Effect in AML. Front Oncol. 2019 Nov 19;9:1217. PMID: 31803612; PMCID: PMC6877747. [CrossRef]
  8. Klingemann HG. Introducing graft-versus-leukemia into autologous stem cell transplantation. J Hematother. 1995 Aug;4(4):261-7. [CrossRef]
  9. Innovation Porrata LF. Autologous Graft-versus-Tumour Effect: Reality or Fiction? Adv Hematol. 2016;2016:5385972. Epub 2016 Aug 22. PMID: 27635143; PMCID: PMC5011204. [CrossRef]
  10. Rahman MM, Madlambayan GJ, Cogle CR, McFadden G. Oncolytic viral purging of leukemic hematopoietic stem and progenitor cells with Myxoma virus. Cytokine Growth Factor Rev. 2010 Apr-Jun;21(2-3):169-75. Epub 2010 Mar 7. PMID: 20211576; PMCID: PMC2881168. [CrossRef]
  11. Staudinger M, Humpe A, Gramatzki M. Strategies for purging CD96+ stem cells in vitro and in vivo: New avenues for autologous stem cell transplantation in acute myeloid leukemia. Oncoimmunology. 2013 Jun 1;2(6):e24500. Epub 2013 Apr 16. PMID: 23894710; PMCID: PMC3716745. [CrossRef]
  12. Bialek-Waldmann JK, Domning S, Esser R, Glienke W, Mertens M, Aleksandrova K, Arseniev L, Kumar S, Schneider A, Koenig J, Theobald SJ, Tsay HC, Cornelius ADA, Bonifacius A, Eiz-Vesper B, Figueiredo C, Schaudien D, Talbot SR, Bleich A, Spineli LM, von Kaisenberg C, Clark C, Blasczyk R, Heuser M, Ganser A, Köhl U, Farzaneh F, Stripecke R. Induced dendritic cells co-expressing GM-CSF/IFN-α/tWT1 priming T and B cells and automated manufacturing to boost GvL. Mol Ther Methods Clin Dev. 2021 Apr 9;21:621-641. PMID: 34095345; PMCID: PMC8142053. [CrossRef]
  13. Solomon SR, Solh M, Morris LE, Holland HK, Bachier-Rodriguez L, Zhang X, Guzowski C, Jackson KC, Brown S, Bashey A. Phase 2 study of PD-1 blockade following autologous transplantation for patients with AML ineligible for allogeneic transplant. Blood Adv. 2023 Sep 26;7(18):5215-5224. PMID: 37379271; PMCID: PMC10500475. [CrossRef]
  14. Spellman SR, Xu K, Oloyede T, Ahn KW, Akhtar O, Bolon YT, Broglie L, Bloomquist J, Bupp C, Chen M, Devine SM, El-Jurdi N, Hamadani M, Hengen M, Huppler AH, Jaglowski S, Kuxhausen M, Lee SJ, Moskop A, Page KM, Pasquini MC, Perez W, Phelan R, Rizzo D, Saber W, Stefanski HE, Steinert P, Tuschl E, Visotcky A, Vogel R, Auletta JJ, Shaw BE, Allbee-Johnson M. Current Activity Trends and Outcomes in Hematopoietic Cell Transplantation and Cellular Therapy - A Report from the CIBMTR. Transplant Cell Ther. 2025 Aug;31(8):505-532.
  15. Hartmann L, Metzeler KH. Clonal hematopoiesis and preleukemia: Genetics, biology, and clinical implications. Genes, Chromosomes, Cancer. 2019 Dec;58(12):828-838. Epub 2019 Apr 16. PMID: 30939217. [CrossRef]
  16. Albornoz D, Mannone L, Nguyen-Quoc S, Chalandon Y, Chevallier P, Mohty M, Meunier M, Robin M, Ledoux MP, Guillerm G, Bay JO, Poiré X, Maillard N, Leclerc M, Daguindau E, Beguin Y, Rubio MT, Gyan E. Allogeneic Stem Cell Transplantation in Therapy-Related Myelodysplasia after Autologous Transplantation for Lymphoma: A Retrospective Study of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy. Biol Blood Marrow Transplant. 2019 Dec;25(12):2366-2374. Epub 2019 Jul 19. PMID: 31326611. [CrossRef]
  17. Alva LC, Bacher U, Seipel K, Mansouri Taleghani B, Mueller BU, Novak U, Pabst T. Iron overload is correlated with impaired autologous stem cell mobilization and survival in acute myeloid leukemia. Transfusion. 2018 Oct;58(10):2365-2373. Epub 2018 Sep 10. PMID: 30203418. [CrossRef]
  18. Gorin NC. History and Development of Autologous Stem Cell Transplantation for Acute Myeloid Leukemia. Clin Hematol Int. 2021 Jul 15;3(3):83-95. PMID: 34820613; PMCID: PMC8486970. [CrossRef]
  19. Pang A, Huo Y, Shen B, Zheng Y, Jiang E, Feng S, Han M. Optimizing autologous hematopoietic stem cell transplantation for acute leukemia. Stem Cells Transl Med. 2021 Nov;10 Suppl 2(Suppl 2):S75-S84. PMID: 34724713; PMCID: PMC8560201. [CrossRef]
  20. Tanada M, Takami A, Mizuno S, Mori J, Chou T, Usuki K, Uchiyama H, Amano I, Fujii S, Miyamoto T, Saito T, Kamimura T, Ichinohe T, Fukuda T, Okamoto S, Atsuta Y, Yano S. Autologous hematopoietic cell transplantation for acute myeloid leukemia in adults: 25 years of experience in Japan. Int J Hematol. 2020 Jan;111(1):93-102. Epub 2019 Oct 14. PMID: 31612307. [CrossRef]
  21. Yeshurun M, Wolach O. Autologous hematopoietic cell transplantation for AML in first remission - An abandoned practice or promising approach? Semin Hematol. 2019 Apr;56(2):139-146. Epub 2019 Feb 14. PMID: 30926090. [CrossRef]
  22. Wang LT, Shih CC, Chen YH, Chang CF, Fan HL, Chen TW, Chen YW, Krupalakshmi S, Lin YF, Shih YL, Hsieh TY, Huang WY, Huang WC. Interferon-α enhances NK cell function to counteract autologous platelet-mediated tumor immune evasion. Cancer Cell Int. 2026 Jan 23;26(1):92. PMID: 41578270; PMCID. [CrossRef]
  23. Romanini N, Netsrithong R, Themeli M, Tazzari M. Challenges and opportunities of human iPSC-derived NK as “Off-the-shelf” cellular therapies. J Exp Clin Cancer Res. 2025 Dec 29;44(1):327. PMID: 41462483; PMCID: PMC12746639. [CrossRef]
  24. Stein J, Anand P, Abdulmajid J, Hartz A, Unterfrauner M, Feng X, Schmieder N, Kruk L, Bojko P, Schmohl J, Schmid C, Filippini Velázquez G, Schmetzer HM. Monitoring of (Leukemia-Specific) Immune Cells in Stages, Treatment Groups and in the Course of Disease and Therapy Contributes to Qualify Antileukemic Potential and Survival in Patients with AML. Int J Mol Sci. 2025 Oct 23;26(21):10336. PMID: 41226377; PMCID: PMC12609274. [CrossRef]
  25. Jung SH, Lee JJ. Update on primary plasma cell leukemia. Blood Res. 2022 Apr 30;57(S1):62-66. PMID: 35483928; PMCID: PMC9057670. [CrossRef]
  26. Drake MB, Iacobelli S, van Biezen A, Morris C, Apperley JF, Niederwieser D, Björkstrand B, Gahrton G; European Group for Blood and Marrow Transplantation and the European Leukemia Net. Primary plasma cell leukemia and autologous stem cell transplantation. Haematologica. 2010 May;95(5):804-9. PMID: 20442444; PMCID: PMC2864387. [CrossRef]
  27. Lemieux C, Johnston LJ, Lowsky R, Muffly LS, Craig JK, Shiraz P, Rezvani A, Frank MJ, Weng WK, Meyer E, Shizuru J, Arai S, Negrin R, Miklos DB, Sidana S. Outcomes with Autologous or Allogeneic Stem Cell Transplantation in Patients with Plasma Cell Leukemia in the Era of Novel Agents. Biol Blood Marrow Transplant. 2020 Dec;26(12):e328-e332. Epub 2020 Sep 19. PMID: 32961371; PMCID: PMC8083942. [CrossRef]
  28. Xu Y, He J, Chen L, Liu J, Zhou M, Chen B, Bai H. Survival improvement in primary plasma cell leukemia: A retrospective analysis of novel agent-based regimens and stem cell transplantation. Front Oncol. 2026 Jan 9;15:1727117. PMID: 41584590. [CrossRef]
  29. Mangoni L, Rizzoli V. Autologous bone marrow transplantation in chronic lymphocytic leukemia (CLL). Biomed Pharmacother. 1996;50(9):442-6. PMID: 899111. [CrossRef]
  30. Schetelig J, Dreger P. Chronic Lymphocytic Leukemia. 2024 Apr 11. In: Sureda A, Corbacioglu S, Greco R, Kröger N, Carreras E, editors. The EBMT Handbook: Hematopoietic Cell Transplantation and Cellular Therapies [Internet]. 8th ed. Cham (CH): Springer; 2024. Chapter 85. PMID: 39437068.
  31. Montserrat E, Gribben JG. Autografting CLL: The game is over! Blood. 2011 Jun 9;117(23):6057-8. Erratum in: Blood. 2011 Dec 22;118(26):6993. PMID: 21659550. [CrossRef]
  32. Alfonso-Pierola A, Martinez-Cuadrón D, Rodríguez-Veiga R, Gil C, Martínez-Sánchez P, Bernal T, Benavente C, Romero-Riquelme MA, Serrano-Lopez J, Bergua JM, García-Boyero R, Tormo M, Herrera P, Sossa-Melo CL, Pérez-Simon JA, Rodríguez-Medina C, Bass-Maturana MF, López-Lorenzo JL, Algarra-Algarra L, Vidriales-Vicente B, Pérez-Encinas M, Barrios-García M, Vives S, Sayas-Lloris MJ, Capurro M, Hidalgo S, Olave M, Cuervo-Lozada D, Lavilla-Rubira E, Casado F, Mena-Durán A, Valero-Nuñez M, Casado-Calderón S, Balerdi A, Torres V, Fernández R, Noriega V, Stevenazzi M, Labrador J, León-Maldonado P, de Rueda-Ciller B, Arce-Fernández O, Amigo ML, Raposo-Puglia JÁ, Solé M, Boluda B, Ayala R, Barragán E, Montesinos P; PETHEMA Group. Long-term benefits of autologous stem cell transplantation versus intensive chemotherapy consolidation for acute myeloid leukemia patients: A propensity score matching analysis from the PETHEMA AML registry. Leukemia. 2025 Sep 1. Epub ahead of print. PMID: 40890512. [CrossRef]
  33. Li Z, Liu Y, Wang Q, Chen L, Ma L, Hao S. Autologous Stem Cell Transplantation Is a Viable Postremission Therapy for Intermediate-Risk Acute Myeloid Leukemia in First Complete Remission in the Absence of a Matched Identical Sibling: A Meta-Analysis. Acta Haematol. 2019;141(3):164-175. Epub 2019 Feb 26. PMID: 30808826; PMCID: PMC6492512. [CrossRef]
  34. Yoon JH, Kim HJ, Park SS, Jeon YW, Lee SE, Cho BS, Eom KS, Kim YJ, Lee S, Min CK, Cho SG, Kim DW, Lee JW, Min WS. Clinical Outcome of Autologous Hematopoietic Cell Transplantation in Adult Patients with Acute Myeloid Leukemia: Who May Benefit from Autologous Hematopoietic Cell Transplantation? Biol Blood Marrow Transplant. 2017 Apr;23(4):588-597. Epub 2017 Jan 12. PMID: 28089879. [CrossRef]
  35. Rodríguez-Arbolí E, Martínez-Cuadrón D, Rodríguez-Veiga R, Carrillo-Cruz E, Gil-Cortés C, Serrano-López J, Bernal Del Castillo T, Martínez-Sánchez MDP, Rodríguez-Medina C, Vidriales B, Bergua JM, Benavente C, García-Boyero R, Herrera-Puente P, Algarra L, Sayas-Lloris MJ, Fernández R, Labrador J, Lavilla-Rubira E, Barrios-García M, Tormo M, Serrano-Maestro A, Sossa-Melo CL, García-Belmonte D, Vives S, Rodríguez-Gutiérrez JI, Albo-López C, Garrastazul-Sánchez MP, Colorado-Araujo M, Mariz J, Sanz MÁ, Pérez-Simón JA, Montesinos P; PETHEMA (Programa Español de Tratamientos en Hematología) and GETH (Grupo Español de Trasplante Hematopoyético y Terapia Celular) Cooperative Groups. Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study. Transplant Cell Ther. 2021 Apr;27(4):311.e1-311.e10. Epub 2021 Jan 8. PMID: 33836871. [CrossRef]
  36. Sula M, Bacher U, Oppliger Leibundgut E, Mansouri Taleghani B, Novak U, Pabst T. Excellent outcome after consolidation with autologous transplantation in patients with core binding factor acute myeloid leukemia. Bone Marrow Transplant. 2020 Aug;55(8):1690-1693. Epub 2019 Dec 3. PMID: 31796871. [CrossRef]
  37. Chen J, Labopin M, Pabst T, Zhang X, Jiang E, Tucci A, Cornelissen J, Meijer E, Khevelidze I, Polge E, Wu D, Mohty M, Gorin NC). Autologous stem cell transplantation in adult patients with intermediate-risk acute myeloid leukemia in first complete remission and no detectable minimal residual disease. A comparative retrospective study with haploidentical transplants of the Global Committee and the ALWP of the EBMT. Bone Marrow Transplant. 2023 Dec;58(12):1322-1330. Epub 2023 Aug 28. PMID: 37640797; PMCID: PMC10691968. [CrossRef]
  38. Nagler A, Galimard JE, Labopin M, Blaise D, Arcese W, Trisolini SM, Wu D, Pigneux A, Van Gorkom G, Rubio MT, Gedde-Dahl T, Huynh A, Lanza F, Gorin NC, Mohty M. Autologous stem cell transplantation (ASCT) for acute myeloid leukemia in patients in first complete remission after one versus two induction courses: A study from the ALWP of the EBMT. Cancer Med. 2023 Jan;12(2):1482-1491. Epub 2022 Jul 26. PMID: 35891608; PMCID: PMC9883552. [CrossRef]
  39. Mohty R, Reljic T, Yassine F, Kettaneh C, Al-Husni D, Keller K, Badar T, Murthy H, Foran J, Kumar A, Kharfan-Dabaja MA. Efficacy of Autologous and Allogeneic Hematopoietic Cell Transplantation in Adults with Acute Promyelocytic Leukemia: Results of a Systematic Review and Meta-Analysis. Transplant Cell Ther. 2024 Jun;30(6):599.e1-599.e10. Epub 2024 Mar 29. PMID: 38554737. [CrossRef]
  40. Costa A, Gurnari C, Scalzulli E, Cicconi L, Guarnera L, Carmosino I, Cerretti R, Bisegna ML, Capria S, Minotti C, Iori AP, Torrieri L, Venditti A, Pulsoni A, Martelli M, Voso MT, Breccia M. Response Rates and Transplantation Impact in Patients with Relapsed Acute Promyelocytic Leukemia. Cancers (Basel). 2024 Sep 21;16(18):3214. PMID: 39335185; PMCID: PMC11429657. [CrossRef]
  41. Yanada M, Matsuda K, Ishii H, Fukuda T, Ozeki K, Ota S, Tashiro H, Uchida N, Kako S, Doki N, Kawakita T, Onishi Y, Takada S, Kondo Y, Tanaka J, Kanda Y, Atsuta Y, Yano S. Allogeneic Hematopoietic Cell Transplantation for Patients with Relapsed Acute Promyelocytic Leukemia. Transplant Cell Ther. 2022 Dec;28(12):847.e1-847.e8. Epub 2022 Sep 28. PMID: 36179987. [CrossRef]
  42. Breccia M. Autologous stem cell transplantation finds a place in acute promyelocytic leukemia. Br J Haematol. 2021 Jan;192(2):237-238. Epub 2020 Nov 20. PMID: 33216973. [CrossRef]
  43. Termuhlen AM, Klopfenstein K, Olshefski R, Rosselet R, Yeager ND, Soni S, Gross TG. Mobilization of PML-RARA negative blood stem cells and salvage with autologous peripheral blood stem cell transplantation in children with relapsed acute promyelocytic leukemia. Pediatr Blood Cancer. 2008 Oct;51(4):521-4. PMID: 18493994. [CrossRef]
  44. Holter Chakrabarty JL, Rubinger M, Le-Rademacher J, Wang HL, Grigg A, Selby GB, Szer J, Rowe JM, Weisdorf DJ, Tallman MS. Autologous is superior to allogeneic hematopoietic cell transplantation for acute promyelocytic leukemia in second complete remission. Biol Blood Marrow Transplant. 2014 Jul;20(7):1021-5. Epub 2014 Mar 30. PMID: 24691221; PMCID: PMC4097890. [CrossRef]
  45. Rees MJ, Spencer A, Browett P, Alvaro F, Purtill D, Crawford J, Milliken S, Lai H, Pullon H, Grigg A. High rate of durable remissions post autologous stem cell transplantation for core-binding factor acute myeloid leukemia in second complete remission. BoneMarrow Transplant. 2020 Nov;55(11):2207-2210. [CrossRef]
  46. Rowe JM, Buck G, Burnett AK, Chopra R, Wiernik PH, Richards SM, Lazarus HM, Franklin IM, Litzow MR, Ciobanu N, Prentice HG, Durrant J, Tallman MS, Goldstone AH; ECOG; MRC/NCRI Adult Leukemia Working Party. Induction therapy for adults with acute lymphoblastic leukemia: Results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood. 2005 Dec 1;106(12):3760-7. Epub 2005 Aug 16. PMID: 16105981. [CrossRef]
  47. Swoboda R, Labopin M, Giebel S, Maertens J, Parovichnikova E, Versluis J, Pavlu J, Kopinska A, Capria S, Raida L, Rambaldi A, Caillot D, Folber F, Nachbaur D, Ozturk M, Aljurf M, Rubio MT, Gorin NC, Lanza F, Nagler A, Mohty M, Ciceri F. Autologous stem cell transplantation for adults with Philadelphia-negative acute lymphoblastic leukemia in first complete remission. A study by the Acute Leukemia Working Party of the EBMT. BMC Cancer. 2025 Apr 28;25(1):787. PMID: 40289118; PMCID: PMC12036279. [CrossRef]
  48. Giebel S, Labopin M, Houhou M, Caillot D, Finke J, Blaise D, Fegueux N, Ethell M, Cornelissen JJ, Forcade E, Yakoub-Agha I, Lussana F, Maertens J, Bourhis JH, Jindra P, Gorin NC, Nagler A, Mohty M. Autologous versus allogeneic hematopoietic cell transplantation for older patients with acute lymphoblastic leukemia. An analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant. 2023 Apr;58(4):393-400. Epub 2023 Jan 7. PMID: 36611097. [CrossRef]
  49. CML Mahon FX, Marit G, Boiron JM, Cony-Makhoul P, Agape P, Pigneux A, Broustet A, Reiffers J. Autologous stem cell transplantation for chronic myeloid leukemia. Recent Results Cancer Res. 1998;144:8-14. PMID: 9304702. [CrossRef]
  50. Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, Duarte RF, Dufour C, Kuball J, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Nagler A, Sureda A, Mohty M. Impact of drug development on the use of stem cell transplantation: A report by the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant. 2017 Feb;52(2):191-196. Epub 2016 Nov 7. PMID: 27819687. [CrossRef]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
Copyright: This open access article is published under a Creative Commons CC BY 4.0 license, which permit the free download, distribution, and reuse, provided that the author and preprint are cited in any reuse.
Prerpints.org logo

Preprints.org is a free preprint server supported by MDPI in Basel, Switzerland.

facebook logotwitter logolinkedin logo
bsky
MDPI Initiatives
Important Links
Subscribe

Disclaimer

Terms of Use

Privacy Policy

Privacy Settings

© 2026 MDPI (Basel, Switzerland) unless otherwise stated