Transplant without salvage: cut out the middleman
In this issue of The Lancet Haematology, Matthias Stelljes and colleagues1 present a compelling exploration of an approach to allogeneic haematopoietic stem-cell transplantation (HSCT) in patients at high risk of relapse or induction-refractory acute myeloid leukaemia. This concept is in stark contrast with the long-upheld orthodoxy of using varying regimens of salvage chemotherapy to induce remission or a morphological leukaemia-free state before transplantation.2 These approaches, while considered to be the standard of care in most institutions, are associated with substantial morbidity, particularly when conventional chemotherapy is used.