AUTOLOGOUS BLOOD STEM-CELL TRANSPLANTATION FOR HEMATOLOGICAL MALIGNANCY - TREATMENT-RELATED MORTALITY OF 2-PERCENT

Background: Lengthy remission or cure has remained elusive for patient s with many of the common haematological malignancies. Thus high dose chemotherapy followed by autologous haemopoietic stem cell transplanta tion is being increasingly utilised in these diseases. Aim: To assess the safety of high dose chemotherapy and autologous stem cell transpla ntation in haematological malignancy. Methods: Forty-eight patients wi th haematological malignancy were given high dose chemotherapy followe d by an infusion of previously cryopreserved autologous peripheral blo od stem cells with (patients with acute myeloid leukaemia [AML]) or wi thout (patients with acute lymphoblastic leukaemia [ALL], chronic myel oid leukaemia, non-Hodgkin's lymphoma, Hodgkin's disease and myeloma) autologous bone marrow. Results: All patients except one had sustained engraftment. The median (range) number of days to attain a neutrophil count of 0.5 x 10(9)/L was 12 (10-42) and a platelet count of 20 x 10 (9)/L unsupported by platelet transfusions was 15 (eight to 155). Othe r than oropharyngeal mucositis and febrile neutropenia, morbidity was low. Two patients had haemorrhagic cystitis, one hepatic veno-occlusiv e disease and one interstitial pneumonitis; all resolved. The treatmen t-related mortality was 2% - a single patient with AML died of failure of sustained engraftment. Conclusions: Autologous blood stem cell tra nsplantation to support high dose chemotherapy is a relatively safe pr ocedure and its efficacy is currently being explored in a wide range o f haematological malignancies.