Proposed clinical approach to ensure low incidence of posttransplant leukemia relapse in high-risk leukemia patients. An algorithm with a proposed approach to support clinicians with the choice of the HCT approach for fit acute leukemia patients at high risk of posttransplant relapse. DRI, Disease Risk Index; HCT, hematopoietic cell transplantation; IS, immune suppression; TBF, thiotepa-busulfa-fludarabine; TTF, thiotepa-treosulfan-fludarabine.