Autologous Bone Marrow Transplantation in Acute Myeloid Leukemia in First Remission: First Dutch Prospective Study

Since it has become possible to induce complete remissions in most patients with acute myeloid leukemia (AML), cytotoxic therapy has been applied during complete remission in efforts to eradicate residual neoplasm. Modern chemotherapy may produce 20%–30% survival at 3 years in adults [1–7]. In adult patients with AML in first remission between 20 and 40 years of age, HLA (human leukocyte antigen) identical bone mar-row transplantation (allo-BMT) has yielded approximately 40% disease-free survival [8–10]. In clinical practice, the applicability of allo-BMT is restricted by complications of graft-versus-host disease (GvHD), stringent age criteria, and the limited availability of HLA-compatible family donors. Marrow ablative chemo- and radiotherapy for eradicating residual AML in combination with autologous bone marrow transplantation (auto-BMT) has been pursued in recent years as an alternative therapeutic modality [11–15].