Acute lymphoblastic leukemia (ALL) is an uncommon malignancy in adults, with an incidence rate of 0.3-0.8 cases/105 individuals between the ages of 20 and 50. In comparison, acute myeloid leukemia (AML) occurs in 1.2-2.4/105 individuals between the ages of 20 and 50.1 Nevertheless, AML and ALL represent the two most common indications for allogeneic stem cell transplantation worldwide, as reported to the International Bone Marrow Transplant Registry in 2002, accounting for over 7000 reported transplants worldwide.2

Modest advances in the therapy for ALL and AML have been made in the last decade; but despite these advances, long-term outcomes for these diseases, particularly in adults, remain poor, as less than half of these patients achieve a durable remission.3 4 This chapter discusses the established and emerging role of allogeneic stem cell transplantation as therapy for the acute leukemias.

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