Autologous bone marrow transplantation in leukemia.
In patients without HLA-identical donors autologous bone marrow transplantation should be considered as an alternative to conservative treatment of recurrent malignancies. Any patient in complete remission is suitable for an autologous bone marrow transplantation. Bone marrow is aspirated from the patient during complete remission, frozen, and stored at -196 degrees C, and it can be used for hematopoietic reconstitution after high-dose chemotherapy and radiotherapy of the patient. In patients with solid malignant tumors or leukemia the elimination of clonogenic tumor cells from the graft by means of physical separation techniques has not been successful. However, studies in mice and more recently in patients indicate that antibodies destroy residual leukemic cells of the bone marrow transplant without jeopardizing the capacity for regeneration. During our first study in children with acute lymphoblastic leukemia, bone marrow was taken from 50 patients in remission and cryopreserved. Preservation time ranged from 1 to 60 months and the mean number of aspirated nucleated bone marrow cells was 4 X 10(8)/kg body weight (1.9 - 7.4 X 10(8)/kg). After cryopreservation the stem cell viability of the standard samples was 80% - 100%. Autologous bone marrow was transplanted in five patients with common ALL (cALL). The transplant was prepared by incubation with specific antisera of high cytotoxic, selective activity against cALL cells. Our preliminary results show that bone marrow cells aspirated in remission and prepared with antileukemic antisera stimulate repopulation of the recipient's bone marrow and effect hematopoietic regeneration.
D000818:Animals; D001853:Bone Marrow / Q000276:immunology; D016026:Bone Marrow Transplantation; D003602:Cytotoxicity, Immunologic; D005615:Freezing; D006801:Humans; D007938:Leukemia / Q000276:immunology / Q000628:therapy*; D007945:Leukemia, Lymphoid / Q000628:therapy; D051379:Mice; D008806:Mice, Inbred AKR; D014021:Tissue Preservation; D014182:Transplantation, Autologous