10 YEARS TRANSPLANTATION OF BONE-MARROW A ND OF HEMATOPOIETIC STEM-CELLS AT THE MEDICAL-SCHOOL HANOVER

Patients and methods: From January 1986 until August 1995 230 adult pa tients received an allogeneic or autologous transplantation of bone ma rrow or hematopoietic blood stem cells. The conditioning and myeloabla tive treatment regimens were chosen according to the underlying diseas e and type: of transplant. Results: The observation period comprises 1 to 115 months after transplantation. After allogeneic transplantation from HLA-identical family donors, the probabilities of disease-free s urvival were for acute myeloid leukemia in first complete remission (C R) (n = 35) 77%, for acute lymphoid leukemia in Ise CR (n = 7) 72% and in 2nd CR (n = 10) 40%, in first chronic phase of chronic myeloid leu kemia (n = 34) 50% and in severe aplastic anemia (n = 7) 100%. Followi ng myeloablative therapy and autologous transplantation the probabilit ies oi disease-free survival were 47% in relapsed Hodgkin's disease (n = 22) and 42% for relapsed high-grade non-Hodgkin's lymphoma (n = 12) . Eight of 10 patients with acute myeloid and 7 of 8 with acute lympho id leukemia suffered a leukemic relapse after autologous bone marrow t ransplantation. Three of 8 patients with relapsed testicular cancer su rvived relapse-free. Treatment failures were due to more advanced acut e graft versus host disease alter allogeneic transplantation and cause d by relapse after autologous transplantation. Current protocols evalu ate the allogeneic transplantation of enriched CD34(+) blood seem cell s. In chronic myeloid leukemia the autologous transplantation of blood stem cells after myeloablative therapy is being studied.