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Bone marrow transplantation in leukemia: Current status
Author(s) -
Santos George W.
Publication year - 1984
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19841201)54:2+<2732::aid-cncr2820541421>3.0.co;2-a
Subject(s) - medicine , leukemia , total body irradiation , lymphoma , bone marrow , immunology , disease , minimal residual disease , transplantation , human leukocyte antigen , chemotherapy , histocompatibility , oncology , cyclophosphamide , antigen
Intensive cytoreductive therapy may be curative in certain hematopoietic malignancies, but its administration is limited by lethal marrow toxicity. Bone marrow transplantation (BMT) provides a way of rescue from this toxicity. The donor may be a human leukocyte antigen (HLA) “matched” sibling (allogeneic), an identical twin (syngeneic), or the patient (autologous). Long remissions and possible cures of 50% to 60% have been reported in acute leukemia after intensive treatment with chemotherapy, with and without total body irradiation, followed by allogeneic BMT. A similar approach has been used in chronic myelocytic leukemia (CML) and in non‐Hodgkin's lymphoma with encouraging results. Results are best in younger patients and those transplanted early in their disease ( i.e. , in the first remission for acute lekemia and in the chronic phase of the disease in CML). Solutions to major problems associated with allogeneic BMT, such as graft‐ versus ‐host disease and viral infections, are being actively pursued. Syngeneic BMT avoids some of the above problems, but relapses appear to be greater. Nevertheless, this approach has produced a significant number of cures. Autologous BMT is the newest approach, and the demonstration that marrow may be purged of residual tumor cells by immunologic or pharmacologic means has engendered enthusiasm for this area of clinical therapeutic investigation.