Autologous Bone Marrow Transplantation

Autologous bone marrow transplantation in the acute leukemias and lymphomas offers potentially curative treatment in patients who do not have a histocompatible, allogeneic donor. Results of marrow autografting in the lymphomas are especially encouraging, with disease-free survivals of 50-60% in patients who have failed primary and secondary treatment regimens. In the acute leukemias, one may expect 20-40% relapse-free survival after autologous marrow transplantation. We feel that ex vivo treatment (“purging”) is necessary to eradicate occult tumor cells from autologous remission marrow in hematological malignancies, but this remains a controversial issue to some investigators. Preliminary studies of autologous bone marrow transplantation are promising in multiple myeloma and certain childhood tumors, and autografting is currently being explored in the treatment of other solid tumors such as adenocarcinoma of the breast.