What kind of AML needs stem cell transplantation therapy A more precise assessment of AML risk and prognosis based on cytogenetic and genetic mutation status has classified AML risk into three groups: low risk, intermediate risk and high risk, with different molecular genetic characteristics, low risk group: karyotype Inv(16), t(8;21) without 9q- or complex karyotype and t(16;16), respectively. Molecular mutations were normal karyotype with separate NPM1 mutation. Intermediate risk group: normal karyotype, +8, -Y, t(9;11) and other karyotypes not in the good and poor groups (<3 abnormalities), molecular mutations are c-kit mutations in t(8;21) or inv(16). High risk group: -5/5q- or -7/7 q-; t(8;21) with 9q- or complex karyotype; inv(3q); 11q23 abnormalities; 20q; 21q; 9q-; t(6;9); t(9;22); 17p abnormalities and complex karyotype (≥3 aberrations,) with molecular mutations as normal karyotype with separate FLT3 mutations. Risk stratification Genetics Molecular mutations Low risk Inv(16), t(8;21) without 9q- or complex karyotype , t(16;16) normal karyotype with separate NPM1 mutation Medium risk Normal, +8, -Y, t(9;11), other karyotypes not in good and poor groups (<3 aberrations) C-KIT in t(8;21) or inv(16) High risk -5/5q- or -7/7 q -;t(8;21) with 9q- or complex karyotype; inv(3q); 11q23 abnormal; 20q; 21q; 9q-; t(6;9); t(9;22); 17p abnormal; complex karyotype (≥3 structures + numbers) normal karyotype with separate FLT3 mutation There is a clear difference in clinical prognosis between the low-risk, intermediate-risk and high-risk groups of patients, and stratification according to the above risk levels The treatment can be individualized to avoid under- or over-treatment. For patients in the low-risk group, intensive chemotherapy or autologous stem cell transplantation based on high-dose cytarabine can be used after induction of remission to improve relapse-free survival and mortality rates. Sibling-to-sibling stem cell transplantation may also be performed for low-risk patients if a fully compatible sibling donor is available. For intermediate-risk and high-risk patients, due to the presence of residual leukemia cells in the body after remission, it is best to perform allogeneic stem cell transplantation after induction of remission. High-dose chemotherapy plus autologous stem cell transplantation is also feasible for some patients in the intermediate risk group for whom no donor can be found. However, patients in the high-risk group are prone to relapse and it is best to perform allogeneic stem cell transplantation as soon as possible after remission.