[Transplantation of autologous bone marrow--a new approach in the treatment of neoplastic hematologic diseases. II. Clinical results in acute leukemia, malignant lymphoma and solid tumors].
In this second part of the review the clinical significance of autologous bone marrow transplantation (ABMT) as treatment for acute leukemias (AL) and malignant lymphomas is described. In most adult patients with AL in complete remission treated with conventional maintenance therapy relapse usually occurs within one year. However, the results of ABMT, as an intensive consolidation treatment in patients with AL in remission show long-term disease-free survival in a proportion of 40% of patients. Even better results have been reported in patients with purged bone marrow, although the difference is not statistically significant. A major problem of ABMT is still the high percentage of relapse (50%), while the probability of treatment related mortality is relatively low (up to 10%). ABMT is also showing good results in the treatment of non-Hodgkin's lymphomas of intermediate and high-grade histology and in Hodgkin's disease in cases refractory to the first line therapy and in sensitive relapse. However, in refractory cases the results are poor. It is noteworthy, that in all disorders treated with ABMT, prospective randomised controlled trials are missing and current data are based on heterogenous groups of patients. In the majority of solid tumors, even escalated doses of radiochemotherapy with ABMT are not able to eradicate malignant disease. In contrast, the results are very good in neuroblastoma. Although ABMT is a relatively complex and aggressive method, it is being increasingly applied to the treatment of haematological malignant diseases and the results obtained so far, are encouraging and showing that ABMT, besides allogeneic BMT, represents a promising potentially curative treatment for selected group of patients.
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Zavod za hematologiju, Klinika za unutarnje bolesti s poliklinikom, Klinicki bolnicki centar, Medicinski fakultet Sveucilista u Zagrebu.
D000208:Acute Disease; D016026:Bone Marrow Transplantation; D006801:Humans; D007938:Leukemia / Q000601:surgery*; D008223:Lymphoma / Q000601:surgery*; D009369:Neoplasms / Q000601:surgery*; D014182:Transplantation, Autologous
Transplantacija autologne kostane srzi--novi pristup lijecenju neoplastickih hematoloskih bolesti. II. dio: klinicki rezultati u akutnih leukemija, malignih limfoma i solidnih tumora.