Objective parameters, such as performance status and comorbidity score, may be used to determine the eligibility of adult patients who have acute leukemia for stem cell transplant. Mark R. Litzow, MD, states that he considers any patient with high-risk, Philadelphia chromosome negative [Ph(-)] acute lymphoblastic leukemia (ALL) to be a candidate for transplant. Litzow comments that it is becoming increasingly difficult to determine the best candidate for transplant, but that it is still important to consider comorbidities, disease status, and donor availability.

Dan Douer, MD, notes that most clinical studies have demonstrated that allogeneic transplants are superior to autologous transplants in ALL; in fact, autologous transplants are not considered in this disease state. Jeffrey Lancet, MD, states that beyond first remission, allogeneic transplant offers the only realistic chance of cure and should be considered in this particular setting.