Risk assessmant for allogeneic transplantation Alois Gratwohl
This chapter addresses the problem of risk assessment prior to allogeneic haematopoietic stem cell transplantation (HSCT) for patients with chronic myeloid leukaemia (CML). It lists the many points to be considered in a careful risk analysis, summarizes the similarities with HSCT for other indications as well as the special situation in CML, and should serve as a basis for patient counselling on an individualized level. At a time of general availability of ‘all information’ for any patient, nothing can replace a personalized assessment between the patient, his or her partner, and the responsible physician. This is particularly true for CML, where an allogeneic HSCT is always associated with initial risk of increased mortality but with hope for improved survival in the long run (Figure 15.1). Depending on the different prognostic factors, the risk of early death as a result of HSCT is higher or lower. The content of this chapter should serve as a starting platform for decision-making.