National and International Experiences with Autologous Bone Marrow Transplantation in Acute Leukemias

At present autologous bone marrow transplantation (ABMT) is a post-remission treatment often used in acute leukemias. To estimate the current status of ABMT it is best to look into the results of the Leukemia Working Party of the European BMT Group (EBMTG), analyzed by Claude Gorin (Paris) [1] and first presented at the EBMTG meeting this year. These results include 1322 patients reported from 54 ABMT groups. Of acute myeloid leukemia (AML) patients within the total population studied, 14% were children and 15% were adults over 45 years. Purging of the autograft was done in one-third of the patients in first complete remission (CR 1) and more frequently in second CR (CR 2), especially in high-risk (HR) patients. The leukemia-free survival (LFS) was 36% in CR 1-standard-risk (SR) patients. There was a distinct trend of different survival in CR 1-SR patients according to the French-American-British Group (FAB) classification: about 50% LFS in Ml and M3, 40% in M2, but only 30% in M5, and 26% in M4. An influence of the pretransplant regimens on the LFS could also be found. The UCH regimen, consisting of cyclophosphamide, cytosine arabinoside, thioguanine, adriamycin and BCNU, seems to be better than others — the LFS was 61%.