Dealing with patients with refractory acute myeloid leukemia (AML) or with those who have relapsed, is challenging, and stem cell transplantation is one of the few therapies that can be offered in these instances. However, most patients who have relapsed are too old to undergo this procedure, so palliative care must be offered in its place to relieve existing symptoms and improve quality of life. Arnold Ganser, MD, from the Hannover Medical School, Hannover, Germany explains how the right balance should be achieved when using aggressive forms of therapy, because mechanisms of resistance in AML are not yet fully understood. Recorded at the 2018 European School of Hematology (ESH) Clinical Updates on Acute Leukemias, held in Budapest, Hungary.