Hematopoietic cell transplantation for acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is a heterogenous disease for which treatment guidelines are constantly developing. Allogeneic hematopoietic cell transplantation (allo-HCT) is an effective modality of treatment for adult patients with ALL but is associated with significant potential toxicities and hence the optimal timing and selection of patients who would benefit most from allo-HCT remains an issue of controversy. Risk-adapted paradigms using minimal residual disease monitoring may help in the selection of patients at the highest risks of relapse. In addition, there remains ongoing research about the optimal conditioning for transplantation, the role of alternative donor sources in the treatment of ALL, and the incorporation of novel agents into the treatment algorithm for ALL. In this chapter, we summarize the latest literature in the field that addresses these issues.