Bone marrow transplantation for chronic lymphocytic leukemia.
The use of bone marrow transplant (BMT) for patients with chronic lymphocytic leukemia (CLL) is a relatively new approach when compared to the use of this therapy for other hematologic malignancies. The long natural history of CLL and significant procedure-related mortality initially deterred the use of BMT for CLL. However, improvement in transplantation procedures and supportive care paved the way for the use of BMT in patients with CLL. There are now multiple reports showing complete remissions with both autologous and allogeneic BMT. The follow-up remains short, therefore, the durability of these remissions remains to be determined. Several innovative approaches to BMT for CLL are now being explored and include non-myeloablative preparative regimens for allogeneic transplants, purging autologous grafts, and induction of graft-versus-leukemia effects. Ultimately, however, long-term disease-free and overall survival will need to be shown before BMT for CLL will gain widespread acceptance.
Flinn
I W
IW
Johns Hopkins Oncology Center, Division of Hematologic Malignancies, Baltimore, MD 21287, USA.
Vogelsang
G
G
D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation / Q000276:immunology; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy*