Allogeneic marrow transplantation inthetreatment ofinfants with cancer

Marrowtransplantation hasprincipally beenusedduring infancy forthetreatment ofnon-malignant disorders suchas theimmunodeficiency syndromes orosteopetrosis (Fischer et al., 1986). Inthese settings either no preparative conditioning isrequired (e.g. severecombinedimmunodeficiency syndrome) or conditioning regimens involving onlyimmunosuppressive/chemotherapeutic drugs(e.g. cyclophosphamide withor without busulfan) are necessaryforsuccessful engraftment ofdonor marrow.Acutelymphoblastic leukaemia (ALL)ina second remission, acutenon-lymphoblastic leukaemia (ANLL)ina first remission anddisseminated neuroblastoma (excluding StageIVS)havebeenthecommonest indications formarrow transplantation forcancerduring infancy, given thegenerally poorprognosis forthese patients following treatment withconventional therapy (Reaman et al., 1985; Grier etal., 1987; Brochstein etal., 1987; Johnson etal., 1988; Graham-Pole etal., 1988). Inthissituation, however, theconditioning regimen hasusually involved total bodyradiation inaddition tohighdosechemotherapy.